Ultrasound-Guided Cannulation of the Brachiocephalic Vein in Neonates and Preterm Infants: A Prospective Observational Study

Oulego-Erróz, Ignacio; Alonso-Quintela, Paula; Terroba-Seara, Sandra; Jiménez-Gónzález, Aquilina; Rodríguez-Blanco, Silvia; Vázquez-Martínez, José Luis

doi:10.1055/s-0037-1608803

Cited by 15 publications

(2 citation statements)

References 27 publications

(35 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Complication rates range from 0% to 9%, with the rate of major complications such as arterial puncture or pneumothorax <1%. 5,[13][14][15][16][17][18][19][20][21][22][23][24][25][26][27] In the present study, the first attempt success rate of US-guided BCV catheterization was 94.6%, and the overall success rate was 100%, which was consistent with the findings in the available literature. No complications developed during the procedure in any case.…”

Section: Discussionsupporting

confidence: 92%

US-guided central venous catheter placement in the neonatal intensive care unit: Brachiocephalic vein or internal jugular vein?

2023

View full text Add to dashboard Cite

Background: Centrally inserted central catheters (CICCs) are commonly used to monitor venous pressure and administer parenteral nutrition and drugs in newborns. In the present study, we evaluated cannulation success rates, cannulation time, and frequency of complications in catheterization of the internal jugular vein (IJV) and brachiocephalic vein (BCV). Methods: The present study included patients who underwent IJV and BCV catheterization under ultrasound (US) guidance. The patients were divided into two groups, IJV and BCV, depending on the vein in which the CICC was utilized. We documented the diameters of the IJVs and BCVs, first attempt and overall success rates, mean cannulation time, and complication rates. Results: A total of 79 patients were evaluated, 37 in the BCV group and 42 in the IJV group. No significant differences were observed between the two groups in terms of sex, mean age, or weight range ( p > 0.05).The mean vein diameter was significantly larger in the BCV group than in the IJV group ( p < 0.001); the mean number of attempts was significantly higher in the IJV group than in the BCV group ( p < 0.001); the mean cannulation time was significantly longer in the IJV group than in the BCV group ( p < 0.001); and the first attempt success rate was 50% in the IJV group, versus 94.6% in the BCV group. The overall success rate was 100% in both groups. The rate of complications was 8.6% in the IJV group, while no complications developed in the BCV group. Conclusions: Given the larger diameter of the vessel, BCV catheterization was found to result in quicker cannulation and lower complication rates. The results of the present study suggest that BCV catheterization should be the first choice for neonatal intensive care unit (NICU) patients who require parenteral support or close venous pressure monitoring.

show abstract

Section: Discussionsupporting

confidence: 92%

US-guided central venous catheter placement in the neonatal intensive care unit: Brachiocephalic vein or internal jugular vein?

2023

View full text Add to dashboard Cite

show abstract

“…But ultrasound-guided cannulation comprehensively achieved an extremely high success rate, 98.32%, in a recent report [15]. Ultrasound-guided cannulation can be adopted at any site—internal jugular vein, subclavian vein, brachiocephalic vein, and so on—and is not limited to adult or child patients [12–15, 17–19]. The wide acceptance of ultrasound-guided insertion makes it a standard procedure for CVC/PICC [17, 20].…”

Section: Discussionmentioning

confidence: 99%

Effect of ultrasound-guided central venous catheter insertion on the incidence of catheter-related bloodstream infections and mechanical complications

et al. 2019

View full text Add to dashboard Cite

Background Central venous catheters (CVCs) are necessary for critically ill patients, including those with hematological malignancies. However, CVC insertion is associated with inevitable risks for various adverse events. Whether ultrasound guidance decreases the risk of catheter-related infection remains unclear. Methods We observed 395 consecutive CVC insertions between April 2009 and January 2013 in our hematological oncology unit. Because the routine use of ultrasound guidance upon CVC insertion was adopted based on our hospital guidelines implemented after 2012, the research period was divided into before December 2011 (early term) and after January 2012 (late term). Results Underlying diseases included hematological malignancies and immunological disorders. In total, 235 and 160 cases were included in the early- and late term groups, respectively. The median insertion duration was 26 days (range, 2–126 days) and 18 days (range, 2–104 days) in the early- and late term groups, respectively. The internal jugular, subclavian, and femoral veins were the sites of 22.6, 40.2, and 25.7% of the insertions in the early term group and 32.3, 16.9, and 25.4% of the insertions in the late term group, respectively. The frequency of catheter-related bloodstream infection (CRBSI) was 1.98/1000 catheter days and 2.17/1000 catheter days in the early- and late term groups, respectively. In the subgroup analysis, the detected causative pathogens of CRBSI did not differ between the two term groups; gram-positive cocci, gram-positive bacilli, and gram-negative bacilli were the causative pathogens in 68.9, 11.5, and 14.8% of the cases in the early term group and in 68.2, 11.4, and 18.2% of the cases in the late term group, respectively. In the multivariate analysis to determine the risk of CRBSI, only age was detected as an independent contributing factor; the indwelling catheter duration was detected as a marginal factor. A significant reduction in mechanical complications was associated with the use of ultrasound guidance. Conclusions Ultrasound-guided CVC insertion did not decrease the incidence of CRBSI. The only identified risk factor for CRBSI was age in our cohort. However, we found that the introduction of ultrasound-guided insertion triggered an overall change in safety management with or without the physicians’ intent.

show abstract

Ultrasound‐guided totally implantable venous access ports placement via right brachiocephalic vein in pediatric population: A clinical debut

Ding

Qiu

et al. 2022

Pediatric Blood & Cancer

View full text Add to dashboard Cite

Background and objectives: To investigate the feasibility and safety of ultrasoundguided totally implantable venous access ports (TIVAPs) via the right brachiocephalic vein (BCV) in pediatric patients.Methods: A single-institute retrospective review was performed on 35 pediatric patients with predominantly hematological malignancies (88.6%) who underwent TIVAP implantation via ultrasound-guided right BCV approach from July 2018 to June 2021. The catheter tip was adjusted to be positioned at the cavoatrial junction under pulsed fluoroscopic guidance. Technical success rate, procedural information, and TIVAP-related complications were evaluated.Results: All the pediatric TIVAP devices were successfully implanted via right BCV access. Venous access was successful by first attempt in 32 children (91%), two cases (5.7%) required a second attempt, and one patient (2.9%) required a third attempt.The mean procedural time was 44.6 ± 6.4 minutes (range: 34-62 minutes). No intraoperative complications occurred. The average TIVAP indwelling time was 564 ± 208 days (range: 193-1014 days), with a cumulative 19,723 catheter-days. Overall, three patients (8.6%) experienced four postoperative complications (two cases of local hematoma and two catheter dysfunctions) at a rate of 0.2 per 1000 catheterdays. No other complications such as wound dehiscence, delayed incision healing, Abbreviations: BCV, brachiocephalic vein; CRBSI, catheter-related bloodstream infection; CRT, catheter-related thrombosis; CVC, central venous catheter; IJV, internal jugular vein; IQR, interquartile range; PICC, peripherally inserted central catheter; SCV, subclavian vein; TIVAP, totally implantable venous access port.

show abstract

Ultrasound-Guided Cannulation of the Brachiocephalic Vein in Neonates and Preterm Infants: A Prospective Observational Study

Abstract: US-guided cannulation of the BCV may be considered in acutely ill neonates, including small preterm infants, who need a large bore CVC.

Cited by 15 publications

References 27 publications

US-guided central venous catheter placement in the neonatal intensive care unit: Brachiocephalic vein or internal jugular vein?

US-guided central venous catheter placement in the neonatal intensive care unit: Brachiocephalic vein or internal jugular vein?

Effect of ultrasound-guided central venous catheter insertion on the incidence of catheter-related bloodstream infections and mechanical complications

Ultrasound‐guided totally implantable venous access ports placement via right brachiocephalic vein in pediatric population: A clinical debut

Contact Info

Product

Resources

About