Ultrasound-guided central venous cannulation in infants and children.
BACKGROUND
Percutaneous central venous cannulation in infants and children is a challenging procedure. Traditionally, an external landmark technique has been used to identify puncture site. An ultrasound-guided technique is now available and we wanted to evaluate this method in children and infants, looking specifically at the ease of use, success rate and complications.


METHODS
Forty-two consecutive infants and children (median 16.5 [0-177] months and 10 [3-45] kg) scheduled for central venous catheter placement were registered. An ultrasound scanner made for guiding puncture of vessels was used. After locating the puncture site, a sterile procedure was performed using an accompanying kit to aid puncture of the vessel.


RESULTS
Cannulation was successful in all patients and we had no complications during insertion of the catheters. The right internal jugular vein was preferred in most patients, and in 95% of the patients the vein was punctured at the first attempt. The median time from start of puncture to aspiration of blood was 12 (3-180) seconds.


CONCLUSIONS
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.
Asheim
P
P
Department of Anesthesia and Intensive Care, Trondheim University Hospital, Trondheim, Norway. tilper@online.no
Mostad
U
U
Aadahl
P
P
D000293:Adolescent; D000768:Anesthesia, General; D002405:Catheterization, Central Venous / Q000009:adverse effects / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D004452:Echocardiography / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007601:Jugular Veins / Q000000981:diagnostic imaging; D008297:Male