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  • Jost, Robert  (2)
  • 2015-2019  (2)
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  • 2015-2019  (2)
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  • 1
    In: Pediatric Anesthesia, Wiley, Vol. 25, No. 9 ( 2015-09), p. 943-949
    Abstract: The supraclavicular ultrasound ( US )‐guided cannulation of the brachiocephalic vein ( BCV ) is one option of central venous line placement in infants. Aim The aim of this prospective study was to evaluate whether there was an association between the optimum ultrasonographic view as obtained of the entire longitudinal extension of the right BCV and the ease of supraclavicular cannulation when using a strict in‐plane technique via a linear US probe in small infants. Methods The US probe was placed in the right supraclavicular region. If the optimum obtainable sonographic view presented the entire longitudinal extension of the right BCV demonstrating clearly its path caudally alongside the pleura, it was graded as I. If, however, only a circular view, i.e., the initial part of the right BCV was obtainable via US , it was graded as II . The right BCV was cannulated by advancing a 22‐gauge i.v. cannula from lateral to medial strictly under the long axis of the US probe under direct US vision into the vein. Results Seventy‐nine infants weighing between 0.8 and 4.5 kg (Median: 3.4 ± 0.09) were included. In 50 (63.3%) patients, the sonographic view was graded as I and in 29 (36.7%) as II . The proportion of patients successfully cannulated on the first attempt was significantly smaller in patients graded as II , i.e., circular, sonographic view of the right BCV than in patients graded as I, i.e., sonographic view of the entire longitudinal extension of the right BCV (41% vs 90%; chi‐square analysis: P   〈  0.01). Conclusion The sonographic view obtainable of the entire longitudinal extension of the right BCV resulted in significantly fewer required cannulation attempts.
    Type of Medium: Online Resource
    ISSN: 1155-5645 , 1460-9592
    URL: Issue
    Language: English
    Publisher: Wiley
    Publication Date: 2015
    detail.hit.zdb_id: 2008564-3
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  • 2
    In: Anesthesiology, Ovid Technologies (Wolters Kluwer Health), Vol. 128, No. 1 ( 2018-01-01), p. 38-43
    Abstract: The aim of this retrospective analysis was to evaluate the clinical effectiveness of the supraclavicular ultrasound-guided cannulation of the brachiocephalic vein in preterm infants. Methods The ultrasound probe was placed in the supraclavicular region so as to obtain the optimum sonographic long-axis view of the brachiocephalic vein. By using a strict in-plane approach the brachiocephalic vein was cannulated by advancing a 22- or 24-gauge iv cannula from lateral to medial under the long axis of the ultrasound probe under real-time ultrasound guidance into the vein. Results One hundred and forty-two cannulations in infants weighing between 0.59 and 2.5 kg (median: 2.1; CI: 2.0 to 2.2) were included. Ultimate success rate was 94% (134 of 142). One cannulation attempt was required in 100 (70%) patients, two attempts in 21 (15%), and three attempts in 13 (9%). The smaller the weight of the infant the more attempts were needed. More attempts also were needed for the right brachiocephalic vein, which was primarily targeted in 75 (53%) neonates. One (1%) inadvertent arterial puncture was noted. Conclusions This supraclavicular, in-plane, real-time, ultrasound-guided cannulation of the brachiocephalic vein seems to be a convenient and effective method to insert central venous catheters in preterm infants.
    Type of Medium: Online Resource
    ISSN: 0003-3022
    RVK:
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2018
    detail.hit.zdb_id: 2016092-6
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