Ultrasonic imaging as an adjunct to femoral venous catheterization in children.
Central venous catheterization is critically important to the management of burned children, but major morbidity is associated with the technical misadventures that can occur when inserting these devices. We used a bedside ultrasound device to facilitate placement of femoral venous catheters in eight edematous children with an average age of 7.0 years, weight of 23 kg, and burn size of 54%. To our knowledge, this is the first report of this technique in children. All children had central venous catheters placed in the femoral position requiring an average of 2 (range, 1 to 4) venepuncture attempts. There were no mechanical complications. We found the needle guide too cumbersome for our small patients, but found that the ability to mark the anatomy with a pen facilitated accurate catheter placement. In most patients, standard external anatomic landmarks are adequate for accurate catheter placement, however, in this initial experience, we found bedside ultrasound imaging to be a useful adjunct in selected patients with massive soft tissue edema.
Sheridan
R L
RL
Shriners Burns Institute, Boston, MA 02114, USA.
Petras
L
L
Lydon
M
M
D000293:Adolescent; D002056:Burns / Q000628:therapy*; D002405:Catheterization, Central Venous / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D005268:Femoral Vein / Q000000981:diagnostic imaging*; D006801:Humans; D019095:Point-of-Care Systems; D018084:Ultrasonography, Interventional / Q000295:instrumentation