Ultrasound-guided cannulation of the great saphenous vein at the ankle in infants.
BACKGROUND
The establishment of peripheral venous access in infants is the most common invasive technique in paediatric anaesthesia. Venous puncture can be challenging due to the small size of vessels in this patient population. The present study was designed to investigate the practicability of ultrasound-guided vascular access to the great saphenous vein (GSV) at the level of the medial malleolus in infants ≤ 12 months.


METHODS
Ninety consecutive infants ≤ 12 months undergoing elective surgery were included in this prospective study and divided into two age groups (0-6 and 7-12 months). After anaesthesia induction with sevoflurane, an ultrasound investigation of both GSVs at the level of the medial malleoli was performed. Subsequently, venous access in one GSV was established under direct ultrasound control. Anatomical ultrasound data and success rates of venous accesses were analysed.


RESULTS
While not deeper relative to the skin, the GSV was significantly larger in older infants. The success rate in infants ≤ 6 months was 96%, whereas in older infants, the success rate was 100%. The overall success rate in all infants was 98%.


CONCLUSIONS
Ultrasound facilitates venous puncture of the GSV in the vast majority of infants ≤ 12 months. Direct visualization via ultrasound is a promising technique for the establishment of venous access in the GSV at the level of the medial malleolus in infants.
Department of Anaesthesia, Intensive Care Medicine and Pain Therapy,  Medical University of Vienna, Vienna,  Austria.
L
L
Triffterer
P
P
Marhofer
H
H
Willschke
A M
AM
Machata
G
G
Reichel
T
T
Benkoe
S C
SC
Kettner
D000367:Age Factors; D000842:Ankle / Q000000981:diagnostic imaging; D001835:Body Weight / Q000502:physiology; D002406:Catheterization, Peripheral / Q000379:methods*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D011446:Prospective Studies; D012501:Saphenous Vein / Q000033:anatomy & histology / Q000000981:diagnostic imaging*; D018084:Ultrasonography, Interventional / Q000379:methods*