Supraclavicular ultrasound-guided catheterization of the brachiocephalic vein in infants and children: A retrospective analysis

Abstract

Objective/Background:Ultrasound (US) facilitates central venous catheter (CVC) placement in children. A new supraclavicular approach using the brachiocephalic vein (BCV) for US-guided CVC placement in very small children has been recently described. In 2012, we changed our departmental standard and used the left BCV as preferred puncture site during CVC placement. In our retrospective analysis, we compared US-guided cannulation of the BCV with other puncture sites (control).Design/Materials and Methods:We performed a retrospective analysis of all CVC cannulations from October 2012 to October 2013 in our department. For cannulation of the BCV, the in-plane technique was used to guide the needle into the target vein.Results:We performed CVC cannulations in 106 children (age 1-day to 18 years). In 29 patients, the weight was <4.5 kg. CVC placement was successful in all patients. The left BCV could be used in 81.1% of all cases. In a Poisson regression model of punctures regressed by age, weight or group (left BCV vs. control), age, weight or the cannulation site did not influence the number of punctures. In a logistic regression model of complications (yes vs. no) regressed by the group (left brachiocephalic vs. control) an odds ratio of 0.15 was observed (95% confidence interval 0.03-0.72, P likelihood ratio test = 0.007).Conclusion:US-guided puncture of the left BCV is a safe method of CVC placement in children. The use of the left BCV was associated with a high success rate in our retrospective analysis.

Centrally inserted central catheters in preterm neonates with weight below 1500 g by ultrasound-guided access to the brachio-cephalic vein

“…Subclavian or BCV cannulation has been reported to be both safe and relatively easy in pediatric and NICUs; 4,5,[8][9][10][11][12][13] in particular, ultrasound-guided catheterization of the BCV is currently seen as a very promising technique in neonates.…”

Epicutaneo-caval catheters in neonates: New insights and new suggestions from the recent literature

“…6 Many papers of the last few years have suggested that ultrasound-guided CICCs are feasible and safe even in very small neonates, with a high percentage of success and minimal risk, in experienced hands. [7][8][9][10][11][12][13][14] CICCs and FICCs offer several advantages not only in terms of performance (high flow, blood withdrawal, etc. ), but also it is likely that they are associated with lower risk of complications (occlusion, secondary malposition, venous thrombosis, mechanical rupture, infection) if compared to ECC.…”

Ultragarsinio Tyrimo Panaudojimas Pediatrinėje Anestezijoje

“…Tyrimo tipas tininis latakas, kurio punkcija gali sukelti chilotoraksą [22]. Atsižvelgiant į mažesnę pneumotorakso tikimybę, CV kateterizacija gali būti atliekama per VJV.…”