Efficacy and safety of ultrasound-guided internal jugular vein catheterization in low birth weight newborn

Abstract

a b s t r a c t a r t i c l e i n f oBackground: Central venous catheterization is not the first choice of vascular access in neonates. Success depends on the size of the vessel and the skill of the health professional performing the procedure. The internal jugular vein provides a predictable path for central venous cannulation, although it is more difficult to cannulate infants than adults and even more difficult in smaller newborns. Methods: We conducted a prospective study in 100 newborns, in which a 4 Fr ultrasound-guided central venous catheter was placed in the right internal jugular vein (RIJV). The study population was low birth weight (LBW) newborns b 2500 g, very low birth weight (VLBW) newborns b 1500 g and extremely low birth weight (ELBW) newborns b1000 g. Results: There were 53% female patients, mean gestational age was 31 weeks, mean weight 1352 g and the CVC was placed at a mean of 12 days of extrauterine life. Birth weight distribution was 39% LBW; 33% VLBW and 28% ELBW. A mean of two (1-8) attempts were necessary with a procedure duration of 16.8 (10-40) minutes. Success of RIJV catheterization was 94%. One attempt was necessary in 50% and up to 5 attempts in 95.7%. Success by weight was VLBW, 97.2%; ELBW, 92.9%; LBW, 91.7%. A venous hematoma occurred in 5% of cases. Conclusions: Ultrasound-guided RIJV cannulation with real-time visualization to gain access to the central venous circulation in low birth weight newborns is effective and safe.

Ultrasound‐guided anatomical evaluation of right internal jugular vein in children aged 0‐2 years: A prospective observational study

“…In our study, we observed that the RIJV was at the anterolateral and lateral positions with respect to the CA in 42.9% and 51.3% of the patients, respectively, and the overlap was 5% at the level in the neck where it showed its widest diameter. Our results were similar only in terms of the incidence of overlap, when compared to the studies by Montes‐Tapia et al 8 and Souza Neto et al 7 However, aside from this similarity, our results were all different from the results of studies by Souza Neto et al, 7 Montes‐Tapia et al, 8 Di Nardo et al, 9 Tailouin et al, 6 and Roth et al, 10 which may be due to differences in the head‐neck positions of the patients or the level of the evaluation of the RIJV in the neck.…”

“…The authors described a head‐neck position similar to ours; however, they evaluated the IJV at a level between the cricoid cartilage and the clavicle. In a study by Montes‐Tapia et al, 8 the RIJV was reported to be anterolateral with respect to the CA in 21% and lateral in 69% of low‐birthweight newborns, whereas the incidence of overlap was reported to be 7% 8 . The authors described a head‐neck position similar to ours, but they evaluated the IJV at the level of the cricoid cartilage.…”

“…The RIJV was previously evaluated for its anatomical position and structure in the neck 6‐10 . In a study by Tailounie et al, 6 the position of the IJV was described by classifying the degree of its overlap with the CA as major (>50%), minor (<50%), or no overlap 6 .…”

Ultrasound-guided central venous catheter insertion in pediatric patients

“…14세 미만 중환자실 환자 대상 무 작위비교연구에서도 같은 술기의 성공률이 더 높았으며 (95% vs. 61%, P < 0.001), 기계적 합병증 발생은 적었 다 25) . 신생아 대상 연구에서도 초음파 유도 삽입의 성공률 이 94%였으며, 신생아에서도 중심적맥관 삽입을 안전하 게 시행 할 수 있었다고 저자들은 보고 하였다 26) . 응급실에 서 시행된 위와 유사한 연구에서도 초음파 이용 시 성공률 이 더 높았다(98% vs. 79%) 7) .…”

Pediyatrik Konjenital Kalp Cerrahisinde Anestezi Uygulamalarimiz

“…Son yıllarda ultrason kullanımı bu sıkıntıları ortadan kaldırmış, komplikasyon oranını düşürmüş ve daha kısa sürede kateter yerleştirilmesini mümkün kılmıştır. Kateter yerleştirmek için en sık tercih edilen ven sağ internal juguler vendir ancak bunun dışındaki diğer venler de bu amaçla kullanılabilmektedir (6,7). Biz kliniğimizde pediyatrik kardiyak cerrahide santral venöz yerleştirilmesinde ultrasonu rutin olarak kullanmaktayız.…”