Effectiveness and complications of ultrasound-guided subclavian vein cannulation in children and neonates

Nardi, Nicolas; Wodey, Éric; Laviolle, Bruno; Brière, François de la; Delahaye, Séverine; Engrand, Charlotte; Gauvrit, Cécile; Dessard, Sabrina; Defontaine, Antoine; Ecoffey, Claude

doi:10.1016/j.accpm.2015.09.007

Cited by 22 publications

(15 citation statements)

References 22 publications

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“…Thus, in these conditions, LUS globally evaluates the lung aeration rather than extravascular lung fluid. [105][106][107]. However, there is no firm consensus about the best technique, i.e., supraclavicular vs infra-clavicular, or in-plane vs outof-plane [101,108].…”

Section: Pocus Is Helpful To Semi-quantitatively Evalu-mentioning

confidence: 99%

International evidence-based guidelines on Point of Care Ultrasound (POCUS) for critically ill neonates and children issued by the POCUS Working Group of the European Society of Paediatric and Neonatal Intensive Care (ESPNIC)

et al. 2020

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Background: Point-of-care ultrasound (POCUS) is nowadays an essential tool in critical care. Its role seems more important in neonates and children where other monitoring techniques may be unavailable. POCUS Working Group of the European Society of Paediatric and Neonatal Intensive Care (ESPNIC) aimed to provide evidence-based clinical guidelines for the use of POCUS in critically ill neonates and children. Methods: Creation of an international Euro-American panel of paediatric and neonatal intensivists expert in POCUS and systematic review of relevant literature. A literature search was performed, and the level of evidence was assessed according to a GRADE method. Recommendations were developed through discussions managed following a Quaker-based consensus technique and evaluating appropriateness using a modified blind RAND/UCLA voting method. AGREE statement was followed to prepare this document. Results: Panellists agreed on 39 out of 41 recommendations for the use of cardiac, lung, vascular, cerebral and abdominal POCUS in critically ill neonates and children. Recommendations were mostly (28 out of 39) based on moderate quality of evidence (B and C). Conclusions: Evidence-based guidelines for the use of POCUS in critically ill neonates and children are now available. They will be useful to optimise the use of POCUS, training programs and further research, which are urgently needed given the weak quality of evidence available.

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Section: Pocus Is Helpful To Semi-quantitatively Evalu-mentioning

confidence: 99%

International evidence-based guidelines on Point of Care Ultrasound (POCUS) for critically ill neonates and children issued by the POCUS Working Group of the European Society of Paediatric and Neonatal Intensive Care (ESPNIC)

et al. 2020

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“…Of the cases summarized in Table 1, a total of 48% was placed in the left and 52% were placed in the right SCV (4, 7–13, 27, 31). The choice of side appears to reflect a personal preference.…”

Section: Right- Versus Left-sided Catheters As First Choicementioning

confidence: 99%

“…The use of a standard IV catheter (7), or a needle with (11) or without (31) an attached syringe has been described. We suggest the use of a 2-Fr needle loosely attached to a 5-mL syringe with a standard luer lock, as the syringe gives the needle a handle that makes the manipulation of the needle easier and allows for verification of the position through aspiration.…”

Section: Technique—the Bicêtre Experiencementioning

confidence: 99%

Supraclavicular Approach to Ultrasound-Guided Brachiocephalic Vein Cannulation in Children and Neonates

Merchaoui¹,

Lausten-Thomsen²,

Pierre³

et al. 2017

Front. Pediatr.

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The correct choice of intra vascular access in critically ill neonates should be individualized depending on the type and duration of therapy, gestational and chronological age, weight and/or size, diagnosis, clinical status, and venous system patency. Accordingly, there is an ongoing demand for optimization of catheterization. Recently, the use of ultrasound (US)-guided cannulation of the subclavian vein (SCV) has been described in children and neonates. This article gives an overview of the current use of US for achieving central venous catheter placement in the SCV or the brachiocephalic vein (BCV) in neonates. More than 1,250 catheters have been reported inserted in children and neonates for a cumulated success rate of 98.4% and the complication rate is reported to be low. The technical aspects of various approaches are discussed, and we offer our recommendation of an US-guided technique for SCV and BCV cannulation based on our experience in a large NICU setting. Although the cannulation the SCV or BCV does not substitute the use of peripherally inserted central catheters or umbilical venous central catheters in neonates, it is a feasible route in very small children who are in need of a large caliber central venous access.

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“…In neonates, infants and children, the ultrasound-guided supraclavicular approach of the brachiocephalic vein (BCV) was recently proposed as an alternative to the classical infraclavicular approach of the subclavian vein, as it was associated with a very high success rate, a very low incidence of accidental arterial puncture and almost no cases of pneumothorax [ 224 – 226 ]. Ultrasound-guided cannulation of the BCV is associated with a higher rate of first attempt success and fewer cannulation attempts compared to other approaches [ 231 , 232 ].…”

Section: Summary Of the Resultsmentioning

confidence: 99%

Expert consensus-based clinical practice guidelines management of intravascular catheters in the intensive care unit

Timsit

Baleine

Bernard

et al. 2020

Ann. Intensive Care

128

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The French Society of Intensive Care Medicine (SRLF), jointly with the French-Speaking Group of Paediatric Emergency Rooms and Intensive Care Units (GFRUP) and the French-Speaking Association of Paediatric Surgical Intensivists (ADARPEF), worked out guidelines for the management of central venous catheters (CVC), arterial catheters and dialysis catheters in intensive care unit. For adult patients: Using GRADE methodology, 36 recommendations for an improved catheter management were produced by the 22 experts. Recommendations regarding catheter-related infections’ prevention included the preferential use of subclavian central vein (GRADE 1), a one-step skin disinfection(GRADE 1) using 2% chlorhexidine (CHG)-alcohol (GRADE 1), and the implementation of a quality of care improvement program. Antiseptic- or antibiotic-impregnated CVC should likely not be used (GRADE 2, for children and adults). Catheter dressings should likely not be changed before the 7th day, except when the dressing gets detached, soiled or impregnated with blood (GRADE 2− adults). CHG dressings should likely be used (GRADE 2+). For adults and children, ultrasound guidance should be used to reduce mechanical complications in case of internal jugular access (GRADE 1), subclavian access (Grade 2) and femoral venous, arterial radial and femoral access (Expert opinion). For children, an ultrasound-guided supraclavicular approach of the brachiocephalic vein was recommended to reduce the number of attempts for cannulation and mechanical complications. Based on scarce publications on diagnostic and therapeutic strategies and on their experience (expert opinion), the panel proposed definitions, and therapeutic strategies.

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Effectiveness and complications of ultrasound-guided subclavian vein cannulation in children and neonates

Abstract: US-guided Sup-SCV catheterisation appears to be fast and safe in children and neonates, even if it remains a little more difficult to achieve in lower-weight patients.

Cited by 22 publications

References 22 publications

International evidence-based guidelines on Point of Care Ultrasound (POCUS) for critically ill neonates and children issued by the POCUS Working Group of the European Society of Paediatric and Neonatal Intensive Care (ESPNIC)

International evidence-based guidelines on Point of Care Ultrasound (POCUS) for critically ill neonates and children issued by the POCUS Working Group of the European Society of Paediatric and Neonatal Intensive Care (ESPNIC)

Supraclavicular Approach to Ultrasound-Guided Brachiocephalic Vein Cannulation in Children and Neonates

Expert consensus-based clinical practice guidelines management of intravascular catheters in the intensive care unit

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