TY - JOUR
T1 - Ultrasound-guided left brachiocephalic vein cannulation in children with underlying bleeding disorders
T2 - A retrospective analysis
AU - Di Nardo, Matteo
AU - Stoppa, Francesca
AU - Marano, Marco
AU - Ricci, Zaccaria
AU - Barbieri, Maria Antonietta
AU - Cecchetti, Corrado
PY - 2014/2
Y1 - 2014/2
N2 - Objectives: To evaluate the safety and effectiveness of ultrasound-guided left brachiocephalic vein cannulation in infants and children with underlying bleeding conditions. Design: Retrospective cohort. Setting: PICU of a tertiary pediatric hospital. Patients: Thirty-four patients requiring central venous catheterization from January 2011 to January 2012. Interventions: None. Measurements and main results: Two pediatric intensivists, experienced in ultrasound-guided vessel cannulation, performed the ultrasound catheterization of the left brachiocephalic vein. Ultrasound equipment consisted of a standard ultrasound monitor with a linear 6-13 MHz probe. The ultrasound monitor was set on a resolution with a depth of 1.8 cm for infants and 2.2 cm for children. The "in-plane" technique was used for all patients. Thirty-four catheterizations were performed. Patient median age was 12.5 months (5.75-63.5 mo) and median weight was 9.25 kg (7-16.25 kg). The population of infants and children analyzed was composed of 25 patients with hematologic disorder (73%) treated with hematopoietic stem cell transplantation, five patients (15%) supported with extracorporeal membrane oxygenation for viral pneumonias, and four patients (12%) with uremic hemolytic syndrome. A 4F catheter was used in 79% of cases. Left brachiocephalic vein cannulation was successful in all 34 patients. Median time needed for cannulation was 350 seconds (277.5-450 s). The overall complication rate was 9% (3 of 34) and consisted of difficulty in advancing the guidewire after having pierced the vein. The time required for catheter positioning and complications was not associated with both lower body weight and body surface area of the patients (p > 0.05). Mean central venous catheter duration was 32 ± 4 days. Conclusions: Data reported in this retrospective study confirm the safety and effectiveness of ultrasound-guided left brachiocephalic vein catheterization in infants and children with underlying bleeding disorders.
AB - Objectives: To evaluate the safety and effectiveness of ultrasound-guided left brachiocephalic vein cannulation in infants and children with underlying bleeding conditions. Design: Retrospective cohort. Setting: PICU of a tertiary pediatric hospital. Patients: Thirty-four patients requiring central venous catheterization from January 2011 to January 2012. Interventions: None. Measurements and main results: Two pediatric intensivists, experienced in ultrasound-guided vessel cannulation, performed the ultrasound catheterization of the left brachiocephalic vein. Ultrasound equipment consisted of a standard ultrasound monitor with a linear 6-13 MHz probe. The ultrasound monitor was set on a resolution with a depth of 1.8 cm for infants and 2.2 cm for children. The "in-plane" technique was used for all patients. Thirty-four catheterizations were performed. Patient median age was 12.5 months (5.75-63.5 mo) and median weight was 9.25 kg (7-16.25 kg). The population of infants and children analyzed was composed of 25 patients with hematologic disorder (73%) treated with hematopoietic stem cell transplantation, five patients (15%) supported with extracorporeal membrane oxygenation for viral pneumonias, and four patients (12%) with uremic hemolytic syndrome. A 4F catheter was used in 79% of cases. Left brachiocephalic vein cannulation was successful in all 34 patients. Median time needed for cannulation was 350 seconds (277.5-450 s). The overall complication rate was 9% (3 of 34) and consisted of difficulty in advancing the guidewire after having pierced the vein. The time required for catheter positioning and complications was not associated with both lower body weight and body surface area of the patients (p > 0.05). Mean central venous catheter duration was 32 ± 4 days. Conclusions: Data reported in this retrospective study confirm the safety and effectiveness of ultrasound-guided left brachiocephalic vein catheterization in infants and children with underlying bleeding disorders.
KW - Children
KW - Left brachiocephalic vein
KW - Pediatric intensive care unit
KW - Ultrasound-guided catheterization
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U2 - 10.1097/01.pcc.0000436200.00089.fb
DO - 10.1097/01.pcc.0000436200.00089.fb
M3 - Article
C2 - 24201856
AN - SCOPUS:84894086606
VL - 15
JO - Pediatric Critical Care Medicine
JF - Pediatric Critical Care Medicine
SN - 1529-7535
IS - 2
ER -