title: Ultrasound-guided supraclavicular cannulation of the brachiocephalic vein in infants: a retrospective analysis of a case series.
abstract: BACKGROUND
  In this study, we analyze the impact of the choice of either the left or right brachiocephalic vein (BCV) on the cannulation success when using the ultrasound-guided supraclavicular in-plane technique approach to the longitudinally viewed BCV in infants.
  
  
  METHODS
  The central vascular protocols of 183 infants were reviewed retrospectively.
  
  
  RESULTS
  The weight ranged from 0.7 to 10 kg. Central venous catheter placement was eventually successful in 98.9%. In 141 patients (82.9%), the left BCV was successfully punctured on the first attempt, in 23 patients (13.5%) after 2 and in 6 patients (3.5%) after 3 attempts. The right BCV was successfully punctured on the first attempt in five patients (38.4%), in three patients (15.3%) after two and in five patients (38.4%) after three attempts, respectively. Significantly more puncture attempts were required for the right BCV (chi-square analysis: P < 0.01). There was also a significant improvement of the success rate over the time course of the case series (Jonckheere-test: P < 0.01).
  
  
  CONCLUSIONS
  It seems to be easier to cannulate the left BCV than the right BCV when using this ultrasound-guided supraclavicular strict in-plane technique. Gaining experience with this method seems to improve the cannulation success.
authors.affiliation: Department of Anaesthesia, Klinikum Klagenfurt, Klagenfurt, Austria. breschan.ch@chello.at
authors.forename: Christian
authors.initials: C
authors.lastname: Breschan
authors.forename: Manuela
authors.initials: M
authors.lastname: Platzer
authors.forename: Robert
authors.initials: R
authors.lastname: Jost
authors.forename: Haro
authors.initials: H
authors.lastname: Stettner
authors.forename: Georg
authors.initials: G
authors.lastname: Feigl
authors.forename: Rudolf
authors.initials: R
authors.lastname: Likar
mesh_terms: D016121:Brachiocephalic Veins / Q000000981:diagnostic imaging*; D002405:Catheterization, Central Venous; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D012189:Retrospective Studies; D018084:Ultrasonography, Interventional