Ultrasound guided internal jugular vein access in children and infant: A meta‐analysis of published studies

Sigaut, Stéphanie; Skhiri, Alia; Stany, Ida; Golmar, Jonathan; Nivoche, Y.; Constant, Isabelle; Murat, I.; Dahmani, Souhayl

doi:10.1111/j.1460-9592.2009.03171.x

Cited by 123 publications

(89 citation statements)

References 27 publications

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“…Ultrasound-guided venous access results in a lower technical failure rate (overall and on first attempt), faster access and a reduction in mechanical complications [32,48,49]. However ultrasound visualisation, puncture and cannulation of central veins in neonates and children require more training and it has a longer learning curve than in adults.…”

Section: Integration In Clinical Practicementioning

confidence: 99%

International evidence-based recommendations on ultrasound-guided vascular access

Lamperti¹,

et al. 2012

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Section: Integration In Clinical Practicementioning

confidence: 99%

International evidence-based recommendations on ultrasound-guided vascular access

Lamperti¹,

et al. 2012

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“…13 In contrast to the literature in adult ED patients, pediatric studies have not uniformly shown an association between US assistance and improved success of CVC placement. 4,5,14 Furthermore, application of the available literature from other pediatric subspecialties may not be appropriate, as the experience of pediatric emergency providers differs from that of providers in other settings. Prior studies assessing the effect of US assistance for CVC placement attempts have occurred in settings where the procedure is performed more often and likely in more controlled environments.…”

Section: Discussionmentioning

confidence: 99%

“…4 In contrast, a recent metaanalysis evaluating five randomized control trials of US guidance for internal jugular vein catheterizations in children and infants found that US guidance had no effect on time to placement or success rate. 5 This meta-analysis, however, focused on study settings other than the pediatric ED, such as in cardiothoracic surgery. In a setting where the procedure is a routine part of care with experienced providers, there may be less benefit gained by adding visualization of the vessels.…”

Section: Discussionmentioning

confidence: 99%

“…Prior studies assessing the effect of US assistance for CVC placement attempts have occurred in settings where the procedure is performed more often and likely in more controlled environments. 5,[14][15][16] A prospective cohort study in the pediatric ICU found decreased time to placement, decreased number of sites attempted, and a decrease in number of attempts by trainees for US-guided CVC placement attempts when compared with placement using the landmark technique. 4 In contrast, a recent metaanalysis evaluating five randomized control trials of US guidance for internal jugular vein catheterizations in children and infants found that US guidance had no effect on time to placement or success rate.…”

Section: Discussionmentioning

confidence: 99%

“…While one prospective investigation set in a pediatric intensive care unit (ICU) demonstrated the value of US assistance, 4 a recent meta-analysis concluded that US assistance was not beneficial for CVC placement in the internal jugular vein in children. 5 We therefore sought to determine if US assistance for CVC placement was associated with an increase in placement success in a pediatric ED. In addition, we studied the effect of US assistance on complication rates.…”

mentioning

confidence: 99%

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Ultrasound Assistance for Central Venous Catheter Placement in a Pediatric Emergency Department Improves Placement Success Rates

Gallagher

Levy

Vieira

et al. 2014

Academic Emergency Medicine

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Objectives: The use of ultrasound (US) has been shown to improve success rates and reduce complications of central venous catheter (CVC) placement in adult emergency department (ED) patients. The authors sought to determine if US assistance for CVC placement is associated with an increased success rate in pediatric ED patients.Methods: This was a retrospective cohort study of CVC placement in a pediatric ED from January 2003 to October 2011. Data were extracted from a procedure log created to record details entered by physicians at the time of CVC placement, including indication, location, complications, and information regarding use of US. All femoral vein and internal jugular vein CVC placement attempts performed by, assisted with, or directly supervised by pediatric emergency physicians (EPs) were included. Characteristics of procedures performed with and without US assistance were compared, controlling for patient and physician factors. The primary outcome was the success rate of CVC placement.Results: There were 168 patients undergoing CVC placement attempts. The proportion of successful placement attempts was significantly higher when using US assistance (96 of 98) compared to those without (55 of 70; 98% vs. 79%, odds ratio [OR] = 13.1, 95% confidence interval [CI] = 2.9 to 59.4). When controlling for patient-and physician-specific factors, success rates remained significantly higher. Prior studies in adults have shown that US assistance for CVC placement is associated with shorter time to placement, decrease in complication rates, and decrease in number of attempts in a variety of clinical settings. 2,3A recent consensus guideline from the American Society of Anesthesiologists recommends use of real-time US guidance for placement of CVCs in the internal jugular and femoral vein sites. In the pediatric emergency department (ED), CVC placement may be performed in the highest acuity patients during emergent resuscitations and in complex patients with poor vascular access, and tools to improve success rates and reduce complications can be highly valuable.The evidence regarding improvement in success of CVC placement with US assistance in children is mixed, and there is a lack of data in the pediatric ED setting. While one prospective investigation set in a pediatric intensive care unit (ICU) demonstrated the value of US assistance, 4 a recent meta-analysis concluded that US assistance was not beneficial for CVC placement in the

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Ultrasound guidance versus anatomical landmarks for internal jugular vein catheterization

Braß

Hellmich

Kolodziej

et al. 2015

Cochrane Database of Systematic Reviews

313

311

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Based on available data, we conclude that two-dimensional ultrasound offers gains in safety and quality when compared with an anatomical landmark technique. Because of missing data, we did not compare effects with experienced versus inexperienced operators for all outcomes (arterial puncture, haematoma formation, other complications, success with attempt number one), and so the relative utility of ultrasound in these groups remains unclear and no data are available on use of this technique in patients at high risk of complications. The results for Doppler ultrasound techniques versus anatomical landmark techniques are also uncertain.

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Ultrasound guided internal jugular vein access in children and infant: A meta‐analysis of published studies

Abstract: This current meta-analysis does not found the utility of ultrasound during IJV access in children and infants in increasing the success rate and in decreasing complications.

Cited by 123 publications

References 27 publications

International evidence-based recommendations on ultrasound-guided vascular access

International evidence-based recommendations on ultrasound-guided vascular access

Ultrasound Assistance for Central Venous Catheter Placement in a Pediatric Emergency Department Improves Placement Success Rates

Ultrasound guidance versus anatomical landmarks for internal jugular vein catheterization

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