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Ultrasound-guided internal jugular vein catheterization in critically ill pediatric patients.

Yang EJ, Ha HS, Kong YH, Kim SJ - Korean J Pediatr (2015)

Bottom Line: Outcome measures included successful insertion of the catheter, cannulation time, number of cannulation attempts, and number and type of resulting complications.Forty-one central venous catheters (93.2%) were successfully inserted into 44 patients (21 males and 23 females; mean age, 6.54±1.06 years).Other complications included 2 reported cases of catheter malposition (4.6%), and 1 case each of arterial puncture (2.3%), pneumothorax (2.3%), and skin infection (2.3%).

View Article: PubMed Central - PubMed

Affiliation: Department of Pediatrics, Chonbuk National University Medical School, Jeonju, Korea.

ABSTRACT

Purpose: Continuous intravenous access is imperative in emergency situations. Ultrasound-guided internal jugular vein (IJV) catheterization was investigated in critically ill pediatric patients to assess the feasibility of the procedure.

Methods: Patients admitted to the pediatric intensive care unit between February 2011 and September 2012 were enrolled in this study. All patients received a central venous catheter from attending house staff under ultrasound guidance. Outcome measures included successful insertion of the catheter, cannulation time, number of cannulation attempts, and number and type of resulting complications.

Results: Forty-one central venous catheters (93.2%) were successfully inserted into 44 patients (21 males and 23 females; mean age, 6.54±1.06 years). Thirty-three patients (75.0%) had neurological disorders. The right IJV was used for catheter insertion in 34 cases (82.9%). The mean number of cannulation attempts and the mean cannulation time was 1.57±0.34 and 14.07±1.91 minutes, respectively, the mean catheter dwell time was 14.73±2.5 days. Accidental catheter removal was observed in 9 patients (22.0%). Six patients (13.6%) reported complications, the most serious being catheter-related sepsis, which affected 1 patient (2.3%). Other complications included 2 reported cases of catheter malposition (4.6%), and 1 case each of arterial puncture (2.3%), pneumothorax (2.3%), and skin infection (2.3%).

Conclusion: The results suggest that ultrasound-guided IJV catheterization can be performed easily and without any serious complications in pediatric patients, even when performed by visiting house staff. Therefore, ultrasound-guided IJV catheterization is strongly recommended for critically ill pediatric patients.

No MeSH data available.


Related in: MedlinePlus

The right internal jugular vein (IJV) lateral to carotid artery (CA) is shown on an ultrosonogram.
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Figure 1: The right internal jugular vein (IJV) lateral to carotid artery (CA) is shown on an ultrosonogram.

Mentions: The IJV on each patient's right side was chosen for the primary insertion attempt. In the case that the initial attempt proved to be unsuccessful, other insertion sites were considered. Before the procedure was performed, the depth, size and position of the IJV were measured (Fig. 1). In addition, it was confirmed in advance that the vein could be compressed via the gentle pressure of a probe on the skin, and that a pulse was present in the carotid artery.


Ultrasound-guided internal jugular vein catheterization in critically ill pediatric patients.

Yang EJ, Ha HS, Kong YH, Kim SJ - Korean J Pediatr (2015)

The right internal jugular vein (IJV) lateral to carotid artery (CA) is shown on an ultrosonogram.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4414628&req=5

Figure 1: The right internal jugular vein (IJV) lateral to carotid artery (CA) is shown on an ultrosonogram.
Mentions: The IJV on each patient's right side was chosen for the primary insertion attempt. In the case that the initial attempt proved to be unsuccessful, other insertion sites were considered. Before the procedure was performed, the depth, size and position of the IJV were measured (Fig. 1). In addition, it was confirmed in advance that the vein could be compressed via the gentle pressure of a probe on the skin, and that a pulse was present in the carotid artery.

Bottom Line: Outcome measures included successful insertion of the catheter, cannulation time, number of cannulation attempts, and number and type of resulting complications.Forty-one central venous catheters (93.2%) were successfully inserted into 44 patients (21 males and 23 females; mean age, 6.54±1.06 years).Other complications included 2 reported cases of catheter malposition (4.6%), and 1 case each of arterial puncture (2.3%), pneumothorax (2.3%), and skin infection (2.3%).

View Article: PubMed Central - PubMed

Affiliation: Department of Pediatrics, Chonbuk National University Medical School, Jeonju, Korea.

ABSTRACT

Purpose: Continuous intravenous access is imperative in emergency situations. Ultrasound-guided internal jugular vein (IJV) catheterization was investigated in critically ill pediatric patients to assess the feasibility of the procedure.

Methods: Patients admitted to the pediatric intensive care unit between February 2011 and September 2012 were enrolled in this study. All patients received a central venous catheter from attending house staff under ultrasound guidance. Outcome measures included successful insertion of the catheter, cannulation time, number of cannulation attempts, and number and type of resulting complications.

Results: Forty-one central venous catheters (93.2%) were successfully inserted into 44 patients (21 males and 23 females; mean age, 6.54±1.06 years). Thirty-three patients (75.0%) had neurological disorders. The right IJV was used for catheter insertion in 34 cases (82.9%). The mean number of cannulation attempts and the mean cannulation time was 1.57±0.34 and 14.07±1.91 minutes, respectively, the mean catheter dwell time was 14.73±2.5 days. Accidental catheter removal was observed in 9 patients (22.0%). Six patients (13.6%) reported complications, the most serious being catheter-related sepsis, which affected 1 patient (2.3%). Other complications included 2 reported cases of catheter malposition (4.6%), and 1 case each of arterial puncture (2.3%), pneumothorax (2.3%), and skin infection (2.3%).

Conclusion: The results suggest that ultrasound-guided IJV catheterization can be performed easily and without any serious complications in pediatric patients, even when performed by visiting house staff. Therefore, ultrasound-guided IJV catheterization is strongly recommended for critically ill pediatric patients.

No MeSH data available.


Related in: MedlinePlus