Utility of ultrasound-guided central venous cannulation in pediatric surgical patients

A clinical series

Galina Leyvi, David G. Taylor, Elizabeth Reith, John D. Wasnick

Research output: Contribution to journalArticle

84 Citations (Scopus)

Abstract

Background: Central venous cannulation can be particularly difficult in pediatric patients. Central line placement is associated with many well-known complications. While ultrasound-guided techniques are well established, the majority of central venous catheters are placed using landmark guidance. This retrospective study compares the safety and efficacy of ultrasound guidance vs landmark guidance in central venous cannulation of pediatric cardiac surgery patients. Methods: The medical records of 149 pediatric patients undergoing cardiac surgery over 3-year period were reviewed. Patients were classified into two cohorts based on whether central venous cannulation of the internal jugular vein was performed by ultrasound or landmark guidance. Overall success and traumatic complication rates were compared between the two groups. Additionally, comparisons between the groups were made to determine if patient size or age affected the success rate of either approach in different manner. Results: Patients in the ultrasound-guided (n = 47) and the landmark-guided (n = 102) groups were similar with respect to age, weight, and surgical procedure for which central venous access was indicated. The overall success rate for cannulation of the internal jugular vein was 91.5% in the ultrasound-guided group and 72.5% in the landmark-guided group (P = 0.010). But in the subgroup of children under 1 year of age, success rate was 77.8% in ultrasound group and 60.9% in landmark group (P = 0.44); in children under 10 kg in weight, success rate was 80% in ultrasound group and 56.7% in landmark group (P = 0.19). There were no significant differences in the rate of traumatic complications between the two methods. Conclusions: The overall success of internal jugular vein cannulation for pediatric cardiac surgery is significantly improved with the use of ultrasound guidance, without a significant difference in traumatic complications. However, mostly children above 1 year of age or 10 kg of weight experience advantages of ultrasound technique.

Original languageEnglish (US)
Pages (from-to)953-958
Number of pages6
JournalPaediatric Anaesthesia
Volume15
Issue number11
DOIs
StatePublished - Nov 2005

Fingerprint

Catheterization
Pediatrics
Jugular Veins
Thoracic Surgery
Weights and Measures
Central Venous Catheters
Medical Records
Retrospective Studies
Safety

Keywords

  • Central venous cannulation
  • Pediatric cardiac surgery
  • Ultrasound vs landmark guidance

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine
  • Pediatrics, Perinatology, and Child Health

Cite this

Utility of ultrasound-guided central venous cannulation in pediatric surgical patients : A clinical series. / Leyvi, Galina; Taylor, David G.; Reith, Elizabeth; Wasnick, John D.

In: Paediatric Anaesthesia, Vol. 15, No. 11, 11.2005, p. 953-958.

Research output: Contribution to journalArticle

Leyvi, Galina ; Taylor, David G. ; Reith, Elizabeth ; Wasnick, John D. / Utility of ultrasound-guided central venous cannulation in pediatric surgical patients : A clinical series. In: Paediatric Anaesthesia. 2005 ; Vol. 15, No. 11. pp. 953-958.
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abstract = "Background: Central venous cannulation can be particularly difficult in pediatric patients. Central line placement is associated with many well-known complications. While ultrasound-guided techniques are well established, the majority of central venous catheters are placed using landmark guidance. This retrospective study compares the safety and efficacy of ultrasound guidance vs landmark guidance in central venous cannulation of pediatric cardiac surgery patients. Methods: The medical records of 149 pediatric patients undergoing cardiac surgery over 3-year period were reviewed. Patients were classified into two cohorts based on whether central venous cannulation of the internal jugular vein was performed by ultrasound or landmark guidance. Overall success and traumatic complication rates were compared between the two groups. Additionally, comparisons between the groups were made to determine if patient size or age affected the success rate of either approach in different manner. Results: Patients in the ultrasound-guided (n = 47) and the landmark-guided (n = 102) groups were similar with respect to age, weight, and surgical procedure for which central venous access was indicated. The overall success rate for cannulation of the internal jugular vein was 91.5{\%} in the ultrasound-guided group and 72.5{\%} in the landmark-guided group (P = 0.010). But in the subgroup of children under 1 year of age, success rate was 77.8{\%} in ultrasound group and 60.9{\%} in landmark group (P = 0.44); in children under 10 kg in weight, success rate was 80{\%} in ultrasound group and 56.7{\%} in landmark group (P = 0.19). There were no significant differences in the rate of traumatic complications between the two methods. Conclusions: The overall success of internal jugular vein cannulation for pediatric cardiac surgery is significantly improved with the use of ultrasound guidance, without a significant difference in traumatic complications. However, mostly children above 1 year of age or 10 kg of weight experience advantages of ultrasound technique.",
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