Ultrasound versus anatomical landmarks: Immediate complications in the central venous catheterization in children under 18 years of age

Rivera-Tocancipá, Daniel; Díaz-Sánchez, Elizabeth; Montalvo-Arce, C.A.

doi:10.1016/j.redare.2018.02.014

Cited by 3 publications

(9 citation statements)

References 18 publications

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“…Internationally, ultrasound is considered gold standard technique to guide vessel puncture, compared to traditional landmark and surgical cut‐down techniques . First attempt success (OR 2.09; 95% CI 1.26–3.46; P ≤ 0.001), reduced procedural complications (OR 0.47; 95% CI 0.24–0.91; P = 0.025) and zero incidence of arterial puncture during CVAD insertion have been reported when using USG, in comparison to blind puncture. Specific patient groups, such as centrally inserted CVADs with an oncology, respiratory and gastroenterology diagnosis, were associated with at least twofold greater odds of requiring multiple insertion attempts.…”

Section: Discussionmentioning

confidence: 99%

Development of a paediatric central venous access device database: A retrospective cohort study of practice evolution and risk factors for device failure

Kleidon

Rickard

Schults

et al. 2019

J Paediatrics Child Health

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Aim To describe practice evolution, complications and risk factors for multiple insertion attempts and device failure in paediatric central venous access devices (CVADs). Methods A paediatric retrospective cohort study using prospectively collected data from CVAD database 2012–2014. Data included were patient (i.e. age, condition), insertion (i.e. indication, device, technique) and removal (complications, dwell). Descriptive statistics and incidence rates were calculated per calendar year and compared. Risk factors for multiple insertion attempts and failure were explored with logistic regression and cox regression, respectively. Results A total of 1308 CVADs were observed over 273 467 catheter‐days in 863 patients. Multiple insertion attempts remained static (14%) and significantly associated with non‐haematological oncology (odds ratio 2.19; 95% confidence interval (CI) 1.08–4.43), respiratory (3.71; 1.10–12.5), gastroenterology (4.18; 1.66–10.5) and other (difficult intravenous access) (2.74; 1.27–5.92). CVAD failure decreased from 35% (2012) to 25% (2014), incidence rate from 1.50 (95% CI 1.25–1.80) to 1.28 (1.06–1.54) per 1000 catheter‐days. Peripherally inserted CVAD failure was significantly associated with lower body weight (per kilogram decrease, hazard ratio (HR) 1.02; 95% CI 1.00–1.03), cephalic vein (1.62; 1.05–2.62), difficult access (1.92; 1.02–3.73), sub‐optimal tip placement (1.69; 1.06–2.69) and gastroenterology diagnosis (2.27; 1.05–4.90). Centrally placed CVAD failure was significantly associated with younger age (per year, HR 1.04; 95% CI 1.00–1.07), tunnelled device (3.38; 2.41–4.73) and gastroenterology diagnosis (1.70; 1.06–2.73). Conclusions While advancement in CVAD practices improved overall CVAD insertion and failure outcomes, further improvements and innovation are necessary to ensure improved vessel health and preservation for children requiring CVAD.

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Section: Discussionmentioning

confidence: 99%

Development of a paediatric central venous access device database: A retrospective cohort study of practice evolution and risk factors for device failure

Kleidon

Rickard

Schults

et al. 2019

J Paediatrics Child Health

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“…35 With the exception of 2 multicenter studies, 19,35 all others were unicentric studies. Of the 23 included studies, 9 were conducted in the United States, * 3 were in Japan, 15, 23, 26 2 were in Brazil, 14,25 1 was in China, 16 1 was in Colombia, 17 1 was in Egypt, 29 1 was in Lebanon, 30 1 was in Russia, 31 1 was in Spain, 35 1 was in Turkey, 20 1 was in Tunisia, 18 and 1 was in the United Kingdom. 32 Fifteen studies examined procedures performed exclusively in the operating room.…”

Section: Study Selection and Characteristicsmentioning

confidence: 99%

“…14,24,35 Three studies evaluated procedures performed in multiples settings. 17,22,25 One study was conducted in the emergency department, 21 and researchers in 1 study did not describe the study settings. 31 Anesthesiologists were operators in 9 studies, 15, 17, 22, 23, 27, 30, 32 -34 surgeons were operators in 5, 17,19,22,25,28 intensivists were operators in 4, 14,22,24,35 and pediatricians were operators in 3.…”

Section: Study Selection and Characteristicsmentioning

confidence: 99%

“…median [interquartile range], 14, 15,27,29,32,35 mean (range), 16,25 and median (range). 23, 33 c Values are shown as mean ± SD, 3,19,22,24,30 median [interquartile range], 14, 15,35 median (range), 17,18 and median. 21, 26 d Values are shown as mean ± SD, 3,19,21,22,28,31 median [interquartile range], 14, 15,32,35 median (range), 17,18 mean (range), 16,20 and median.…”

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confidence: 99%

“…23, 33 c Values are shown as mean ± SD, 3,19,22,24,30 median [interquartile range], 14, 15,35 median (range), 17,18 and median. 21, 26 d Values are shown as mean ± SD, 3,19,21,22,28,31 median [interquartile range], 14, 15,32,35 median (range), 17,18 mean (range), 16,20 and median. 26,27 TABLE 1 Continued by guest on July 31, 2020 www.aappublications.org/news Downloaded from DE SOUZA et al 14supervised data collection and critically reviewed the manuscript for important intellectual content; and all authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.This trial has been registered with the PROSPERO Register (identifier CRD42018091333).…”

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Ultrasound Guidance for Pediatric Central Venous Catheterization: A Meta-analysis

et al. 2018

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Dr de Souza conceptualized and designed the study, drafted the initial manuscript, and reviewed and revised the manuscript; Drs de Souza and Nadal designed the data collection instruments, collected data, conducted the initial analyses, and reviewed and revised the manuscript; Drs Brandão and Nogueira coordinated and To cite: de Souza TH, Brandão MB, Nadal JAH, et al. Ultrasound Guidance for Pediatric Central Venous Catheterization: A Meta-analysis. Pediatrics. 2018;142(5):e20181719CONTEXT: Central venous catheterization is routinely required in patients who are critically ill, and it carries an associated morbidity. In pediatric patients, the procedures can be difficult and challenging, predominantly because of their anatomic characteristics. OBJECTIVE:To determine whether ultrasound-guided techniques are associated with a reduced incidence of failures and complications when compared with the anatomic landmark technique. DATA SOURCES:We conducted a systematic search of PubMed and Embase. STUDY SELECTION:We included randomized controlled trials and nonrandomized studies in which researchers compare ultrasound guidance with the anatomic landmark technique in children who underwent central venous catheterization.DATA EXTRACTION: Study characteristics, sample sizes, participant characteristics, settings, descriptions of the ultrasound technique, puncture sites, and outcomes were analyzed. Pooled analyses were performed by using random-effects models. RESULTS:A total of 23 studies (3995 procedures) were included. Meta-analysis revealed that ultrasound guidance significantly reduced the risk of cannulation failure (odds ratio = 0.27; 95% confidence interval: 0.17-0.43), with significant heterogeneity seen among the studies. Ultrasound guidance also significantly reduced the incidence of arterial punctures (odds ratio = 0.34; 95% confidence interval: 0.21-0.55), without significant heterogeneity seen among the studies. Similar results were observed for femoral and internal jugular veins. LIMITATIONS: Potential publication bias for cannulation failure and arterial puncture was detected among the studies. However, no publication bias was observed when analyzing only the subgroup of randomized clinical trials.CONCLUSIONS: Ultrasound-guided techniques are associated with a reduced incidence of failures and inadvertent arterial punctures in pediatric central venous catheterization when compared with the anatomic landmark technique. median [interquartile range], 14, 15,27,29,32,35 mean (range), 16,25 and median (range). 23, 33 c Values are shown as mean ± SD, 3,19,22,24,30 median [interquartile range], 14, 15,35 median (range), 17,18 and median. 21, 26 d Values are shown as mean ± SD, 3,19,21,22,28,31 median [interquartile range], 14, 15,32,35 median (range), 17,18 mean (range), 16,20 and median. 26,27 TABLE 1 Continued by guest on July 31, 2020 www.aappublications.org/news Downloaded from DE SOUZA et al 14supervised data collection and critically reviewed the manuscript for important intellectual content; and all ...

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Implementation of modified Seldinger technology for percutaneous catheterization in critically ill newborns

Pereira

Secco

Arrué

et al. 2023

Rev. esc. enferm. USP

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Objective: To describe the implementation of Modified Seldinger Technology for percutaneous catheterization in critically ill newborns. Method: A quasi-experimental before- and-after study, carried out with neonatologist nurses in a Neonatal Intensive Care Unit. Results: Seven nurses participated in the research. Catheter pre-insertion, insertion and maintenance were assessed using the conventional and modified Seldinger technique. Reliability was satisfactory in pre-test, 5.40 (Md = 6.00), and post-test, 5.94 (Md = 7.00), and perfect in the items about device insertion and maintenance. There was low assertiveness in the items on indication, microintroduction procedure via ultrasound, limb repositioning and disinfection of connections/connectors. Conclusion: Despite the Modified Seldinger Technique expanding some stages of execution over the traditional method of percutaneous catheterization, nurses were more assertive after theoretical-practical training. The technology was implemented and is in the process of being implemented in the health service.

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Ultrasound versus anatomical landmarks: Immediate complications in the central venous catheterization in children under 18 years of age

Cited by 3 publications

References 18 publications

Development of a paediatric central venous access device database: A retrospective cohort study of practice evolution and risk factors for device failure

Development of a paediatric central venous access device database: A retrospective cohort study of practice evolution and risk factors for device failure

Ultrasound Guidance for Pediatric Central Venous Catheterization: A Meta-analysis

Implementation of modified Seldinger technology for percutaneous catheterization in critically ill newborns

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