The Anatomic Relationship of Femoral Vein to Femoral Artery in Euvolemic Pediatric Patients by Ultrasonography: Implications for Pediatric Femoral Central Venous Access

Warkentine, Fred H.; Pierce, Mary Clyde; Lorenz, Doug; Kim, In K.

doi:10.1111/j.1553-2712.2008.00087.x

Cited by 62 publications

(67 citation statements)

References 8 publications

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“…Changes in leg position may reduce this overlap, but this will require immobilizing the patient in the optimal position throughout the procedure [362, 363]. …”

Section: Ultrasound-guided Proceduresmentioning

confidence: 99%

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Pediatric emergency medicine point-of-care ultrasound: summary of the evidence

et al. 2016

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The utility of point-of-care ultrasound is well supported by the medical literature. Consequently, pediatric emergency medicine providers have embraced this technology in everyday practice. Recently, the American Academy of Pediatrics published a policy statement endorsing the use of point-of-care ultrasound by pediatric emergency medicine providers. To date, there is no standard guideline for the practice of point-of-care ultrasound for this specialty. This document serves as an initial step in the detailed “how to” and description of individual point-of-care ultrasound examinations. Pediatric emergency medicine providers should refer to this paper as reference for published research, objectives for learners, and standardized reporting guidelines.

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“…Changes in leg position may reduce this overlap, but this will require immobilizing the patient in the optimal position throughout the procedure [362, 363]. …”

Section: Ultrasound-guided Proceduresmentioning

confidence: 99%

“…The femoral vein may be completely or partially overlapped by the femoral artery in 12 % of patients. Therefore, visualization by ultrasound is recommended prior to femoral vein catheterization [424]. …”

Section: Ultrasound-guided Proceduresmentioning

confidence: 99%

Pediatric emergency medicine point-of-care ultrasound: summary of the evidence

et al. 2016

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“…Ultrasound studies have shown that as many as 12% of femoral vessels in children ages 0 to 9 are either partially or completely overlapping. 13 Thus, attempts at venous access can easily result in inadvertent arterial punctures, especially if done without ultrasound guidance. The use of larger-sized arterial catheters also predisposes the child to vasospasm, resulting in potential limb ischemia.…”

Section: Anatomic and Physiologic Considerationsmentioning

confidence: 99%

Pediatric Vascular Injury

Cannon¹,

Villamaria²,

Peck³

2016

Rich's Vascular Trauma

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“…Previous vascular studies have attempted to characterize these variables, with specific attention to the concept of overlap. [5][6][7][8] These investigations have provided limited quantitative information about the amount of overlap, however, and did not examine the amount of exposed vein. The amount of exposed femoral vein is arguably the most important factor in determining the success of central venous access.…”

Section: Ré Sumémentioning

confidence: 99%

“…Over a 12-week period, a random sampling of 180 participants who presented to the ED were enrolled. A priori sample size calculation based on previous pediatric data by Warkentine and colleagues 8 , estimated that 180 participants would be necessary to achieve 90% power.Twenty-four 4-hour blocks of time were randomly selected over the enrolment period. During these blocks, consecutive patients were approached for enrolment based on their presentation time.…”

Section: Study Design and Selection Of Participantsmentioning

confidence: 99%

Bedside ultrasonography detects significant femoral vessel overlap: implications for central venous cannulation

Beaudoin

Merchant

Lincoln

et al. 2011

CJEM

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Objective: Our goal was to gain a better understanding of the femoral vessel anatomy as it relates to central venous cannulation. The primary objective of this study was to use bedside ultrasonography to determine the amount of exposed femoral vein at three sites corresponding to surface anatomy of the landmark-based procedure. Methods: This cross-sectional study enrolled a random sample of 180 adult patients presenting to a large urban academic emergency department. Subjects underwent standardized ultrasonography to identify and measure the depth and diameter of the femoral vessels and amount of exposed femoral vein at the level of the inguinal ligament (0 cm) 2 cm and 4 cm below. Repeated measures analysis of variance was used to determine significant relationships between vessel measurements and distance from the inguinal ligament. Results: The median age was 44.5 (range 19-90) years; 101 patients were male. The mean (6 SD) percentage of exposed vein at the inguinal ligament was 83% (6 21). This decreased significantly (p , 0.01) with increasing distance from the inguinal ligament: 65% (6 25) at 2 cm and 56% (6 30) at 4 cm. At every distance away from the inguinal ligament, there were some subjects with no vein exposed. Conclusion: This study demonstrates significant overlap of the femoral vessels at sites where landmark-based femoral vein cannulation is often attempted. Our results suggest that ultrasound guidance would be beneficial as femoral vein cannulation may be difficult or impossible in certain individuals owing to anatomic variations. RÉ SUMÉObjectif: Notre objectif é tait d'acqué rir une meilleure compré hension de l'anatomie des vaisseaux fé moraux en ce qui concerne la canulation veineuse centrale. L'objectif principal de cette é tude é tait d'utiliser l'é chographie au chevet pour dé terminer la portion de la veine fé morale exposé e à trois points correspondant à l'anatomie de surface en utilisant la technique des points de repè res. Mé thodes: Dans le cadre de cette é tude transversale, un é chantillon alé atoire, composé de 180 adultes qui se sont pré senté s au service d'urgence d'un grand centre universitaire en milieu urbain, a é té utilisé . Les sujets ont subi une é chographie standardisé e pour dé tecter et mesurer la profondeur et le diamè tre des vaisseaux fé moraux et la portion de veine fé morale exposé e au niveau du ligament inguinal (à 0 cm), à 2 cm et à 4 cm en-dessous. Une analyse de variance à mesures ré pé té es a é té effectué e pour dé terminer les relations significatives entre les mesures des vaisseaux et la distance entre la veine et le ligament inguinal. Ré sultats: L'â ge mé dian é tait de 44,5 ans (fourchette de 19 à 90 ans); 101 patients é taient de sexe masculin. La moyenne (6 s) en pourcentage de la veine exposé e au ligament inguinal é tait de 83 % (6 21). Cela diminuait de faç on significative (p ,0,01) avec l'augmentation de la distance la sé parant du ligament inguinal : de 65 % (6 25) à 2 cm et de 56 % (6 30) à 4 cm. À chaque point distant du ligament ...

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The Anatomic Relationship of Femoral Vein to Femoral Artery in Euvolemic Pediatric Patients by Ultrasonography: Implications for Pediatric Femoral Central Venous Access

Abstract: Background: Knowledge of the femoral vein (FV) anatomy in pediatric patients is important in the selection of appropriate size central line catheters as well as the approach to central venous access. This knowledge may avoid potential complications during central line access.

Cited by 62 publications

References 8 publications

Pediatric emergency medicine point-of-care ultrasound: summary of the evidence

Pediatric emergency medicine point-of-care ultrasound: summary of the evidence

Pediatric Vascular Injury

Bedside ultrasonography detects significant femoral vessel overlap: implications for central venous cannulation

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