Ultrasound‐guided central venous cannulation in infants and children

Åsheim, P.; Mostad, Ulf; Aadahl, Petter

doi:10.1034/j.1399-6576.2002.460410.x

Cited by 86 publications

(60 citation statements)

References 8 publications

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“…Although the authors found that the overall success rate for US-guided catheterisation was higher than that for AL-based catheterisation (94.7% vs. 75.9%), no difference was found between the two methods for patients aged below one year and for patients who weighed less than 10 kg. (27) Asheim et al's study, (28) which involved 42 paediatric patients aged 0-177 months and weighing 3-45 kg, reported a 100% success rate in US-guided CVCs (95% at the first attempt) and no complications. Denys et al (20) also reported a 100% success rate in US-guided CVCs (78% at the first attempt).…”

Section: Discussionmentioning

confidence: 99%

The effects of the Trendelenburg position and the Valsalva manoeuvre on internal jugular vein diameter and placement in children

Dinçyürek

Moğol

Türker

et al. 2015

smedj

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INTRODUCTIONWe compared the effects of various surgical positions, with and without the Valsalva manoeuvre, on the diameter of the right internal jugular vein (RIJV). METHODSWe recruited 100 American Society of Anesthesiologists physical status class I patients aged 2-12 years. The patients' heart rate, blood pressure, peripheral oxygen saturation and end-tidal CO 2 pressure were monitored. Induction of anaesthesia was done using 1% propofol 10 mg/mL and fentanyl 2 μg/kg, while maintenance was achieved with 2% sevoflurane in a mixture of 50/50 oxygen and air (administered via a laryngeal mask airway). The RIJV diameter was measured using ultrasonography when the patient was in the supine position. Thereafter, it was measured when the patient was in the supine position + Valsalva, followed by the Trendelenburg, Trendelenburg + Valsalva, reverse Trendelenburg, and reverse Trendelenburg + Valsalva positions. A 15° depression or elevation was applied for the Trendelenburg position, and an airway pressure of 20 cmH 2 O was applied in the Valsalva manoeuvre. During ultrasonography, the patient's head was tilted 20° to the left. CONCLUSION In paediatric patients, the application of the Trendelenburg position with the Valsalva manoeuvre gave the greatest increase in RIJV diameter. The reverse Trendelenburg position had no significant effect on RIJV diameter. RESULTS

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Section: Discussionmentioning

confidence: 99%

The effects of the Trendelenburg position and the Valsalva manoeuvre on internal jugular vein diameter and placement in children

Dinçyürek

Moğol

Türker

et al. 2015

smedj

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“…Die Punktion der VJI unter sonographischer Bildgebung ist eine Methode, die die Erfolgsquote der zentralvenösen Kanülierung deutlich steigert [1,3,8,19]. Die Darstellung des Gefäßquerschnitts und seiner unmittelbaren Umgebung erlaubt ein weit gehend kontrolliertes Vorschieben der Kanüle und erhöht die Trefferwahrscheinlichkeit vermutlich auch dann, wenn auf eine Kopftieflagerung des Patienten und eine Beatmung mit PEEP verzichtet wird.…”

Section: R Larsen Homburg/saarunclassified

“…Fehl-bzw.Mehrfachpunktionen sind aber häufig Ursache oder Wegbereiter von Komplikationen, die durch eine unzureichende Venenfüllung, die anatomischen Verlaufs-oder Durchmesservarianten und thrombotisch bedingte Wandveränderungen nach stattgehabter Kanü-lierung begünstigt werden [1,2,3,7]. Komplikationen,wie die akzidentelle Karotispunktion oder ein Pneumothorax, Nervenläsionen oder eine extradurale Kanülenposition,sollen mit einer Häufig-keit von 8-25% auftreten [5,10,13,18,19].…”

Section: Diskussionunclassified

“…Verghese et al demonstrierten vor 3 Jahren, dass die Rate der erfolgreichen Punktionen bei Kindern durch die ultraschallgesteuerte Lokalisation der VJI auf 100% zu steigern und zugleich die oben genannten Komplikationen sicher zu vermeiden waren [19].Andere Arbeiten bestätigten dieses Ergebnis und zeigten die Überle-genheit gegenüber der konventionellen Methode der orientierenden Palpation [3,20].Allerdings wurden auch in diesen und anderen Untersuchungen zur ultraschallgesteuerten Punktion die Patienten in Trendelenburg-Position gelagert, so dass bislang nicht ersichtlich war, ob die Methode der ultraschallgesteuerten Punktion bei beatmeten Neugeborenen, Andere Zugangswege für die zentralvenöse Kanülierung, wie über eine Punktion der V. femoralis oder der V. subclavia, stellen eine Alternative zur Punktion der VJI dar, werden aber wegen der Risiken der Gefäßthrombosierung oder der akzidentellen Pleurapunktion ungern gewählt. Die Ergebnisse unserer Arbeit zeigen, dass die ultraschallgesteuerte Kanülierung über die VJI unter Verzicht auf die üblichen venenfüllenden Maßnahmen einen nahezu 100%igen Punktionserfolg bei gleichzeitiger Vermeidung von Komplikationen garantiert und deshalb in den meisten Fällen andere Zugangswege erübrigt.…”

Section: Diskussionunclassified

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Ultraschallgesteuerte zentralvenöse Punktion bei neuropädiatrischen Patienten unter Vermeidung von potentiell hirndrucksteigernden Maßnahmen

Trautner¹,

Greim²,

Arzet³

et al. 2003

Der Anaesthesist

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“…Nevertheless, early it was manifest that the use of US lead to an increased rate of successful insertion (both on the whole and at the initial try), quicker cannulation and a reduced rate of insertion-related adverse events [102,105,106] . In recent years, several studies [100][101][102][107][108][109][110] and meta-analyses [38,105,111] compared the "blind" approach to US-guided approach in pediatric patients and stated that the latter is much more effective and safe. According to the guidelines recommendations, US-guided catheter insertion is recommend as the primary method and not as a subsequent choice or a "salvage" technique in case of failure [99] .…”

Section: Neonates Infants Childrenmentioning

confidence: 99%

Focus on peripherally inserted central catheters in critically ill patients

Cotogni

Pittiruti

2014

WJCCM

105

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Venous access devices are of pivotal importance for an increasing number of critically ill patients in a variety of disease states and in a variety of clinical settings (emergency, intensive care, surgery) and for different purposes (fluids or drugs infusions, parenteral nutrition, antibiotic therapy, hemodynamic monitoring, procedures of dialysis/apheresis). However, healthcare professionals are commonly worried about the possible consequences that may result using a central venous access device (CVAD) (mainly, bloodstream infections and thrombosis), both peripherally inserted central catheters (PICCs) and centrally inserted central catheters (CICCs). This review aims to discuss indications, insertion techniques, and care of PICCs in critically ill patients. PICCs have many advantages over standard CICCs. First of all, their insertion is easy and safe -due to their placement into peripheral veins of the armand the advantage of a central location of catheter tip suitable for all osmolarity and pH solutions. Using the ultrasound-guidance for the PICC insertion, the risk of hemothorax and pneumothorax can be avoided, as well as the possibility of primary malposition is very low. PICC placement is also appropriate to avoid post-procedural hemorrhage in patients with an abnormal coagulative state who need a CVAD. Some limits previously ascribed to PICCs (i.e. , low flow rates, difficult central venous pressure monitoring, lack of safety for radio-diagnostic procedures, single-lumen) have delayed their start up in the intensive care units as common practice. Though, the recent development of power-injectable PICCs overcomes these technical limitations and PICCs have started to spread in critical care settings. Two important take-home messages may be drawn from this review. First, the incidence of complications varies depending on venous accesses and healthcare professionals should be aware of the different clinical performance as well as of the different risks associated with each type of CVAD (CICCs or PICCs). Second, an inappropriate CVAD choice and, particularly, an inadequate insertion technique are relevant-and often not recognized-potential risk factors for complications in critically ill patients. We strongly believe that all healthcare professionals involved in the choice, insertion or management of CVADs in critically ill patients should know all potential risk factors of complications. This knowledge may minimize complications and guarantee longevity to the CVAD optimizing the risk/benefit ratio of CVAD insertion and use. Proper management of CVADs in critical care saves lines and lives. Much evidence from the medical literature and from the clinical practice supports our belief that, compared to CICCs, the so-called power-injectable peripherally inserted central catheters are a good alternative choice in critical care. 80November 4, 2014|Volume 3|Issue 4| WJCCM|www.wjgnet.com access devices (CVADs) are key elements of management for either adult or pediatric critically ill patients. Healthcare pro...

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Ultrasound‐guided central venous cannulation in infants and children

Abstract: The ultrasound-guided technique for placement of central venous catheters was easy to apply in infants and children. It is our impression that it increased the precision and safety of the procedure in this group of patients.

Cited by 86 publications

References 8 publications

The effects of the Trendelenburg position and the Valsalva manoeuvre on internal jugular vein diameter and placement in children

The effects of the Trendelenburg position and the Valsalva manoeuvre on internal jugular vein diameter and placement in children

Ultraschallgesteuerte zentralvenöse Punktion bei neuropädiatrischen Patienten unter Vermeidung von potentiell hirndrucksteigernden Maßnahmen

Focus on peripherally inserted central catheters in critically ill patients

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