In:
Pediatric Critical Care Medicine, Ovid Technologies (Wolters Kluwer Health), Vol. 21, No. 11 ( 2020-11), p. e996-e1001
Abstract:
The aim of this study was to compare the occurrence of posterior wall puncture between the long-axis in-plane and the short-axis out-of-plane approaches in a randomized controlled trial of pediatric patients who underwent cardiovascular surgery under general anesthesia. Design: Prospective randomized controlled trial. Setting: Operating room of Osaka Women’s and Children’s Hospital. Patients: Pediatric patients less than 5 years old who underwent cardiovascular surgery. Interventions: Ultrasound-guided central venous catheterization using the long-axis in-plane approach and short-axis out-of-plane approach. Measurements and Main Results: The occurrence of posterior wall puncture was compared between the long-axis in-plane and short-axis out-of-plane approaches for ultrasound-guided central venous catheterization. Patients were randomly allocated to a long-axis group or a short-axis group and underwent ultrasound-guided central venous catheterization in the internal jugular vein using either the long-axis in-plane approach (long-axis group) or the short-axis out-of-plane approach (short-axis group). After exclusion, 97 patients were allocated to the long-axis ( n = 49) or short-axis ( n = 48) groups. Posterior wall puncture rates were 8.2% (4/49) and 39.6% (19/48) in the long-axis and short-axis groups, respectively (relative risk, 0.21; 95% CI, 0.076–0.56; p = 0.0003). First attempt success rates were 67.3% (33/49) and 64.6% (31/48) in the long-axis and short-axis groups, respectively (relative risk, 1.04; 95% CI, 0.78–1.39; p = 0.77). Overall success rates within 20 minutes were 93.9% (46/49) and 93.8% (45/48) in the long-axis and short-axis groups, respectively (relative risk, 0.99; 95% CI, 0.90–1.11; p = 0.98). Conclusions: The long-axis in-plane approach for ultrasound-guided central venous catheterization is a useful technique for avoiding posterior wall puncture in pediatric patients, compared with the short-axis out-of-plane approach.
Type of Medium:
Online Resource
ISSN:
1529-7535
DOI:
10.1097/PCC.0000000000002476
Language:
English
Publisher:
Ovid Technologies (Wolters Kluwer Health)
Publication Date:
2020
detail.hit.zdb_id:
2070997-3
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