title: Supraclavicular ultrasound-guided catheterization of the subclavian vein in pediatric and neonatal ICUs: a feasibility study.
abstract: OBJECTIVE
  To assess the feasibility of ultrasound-guided supraclavicular catheterization of the subclavian vein in pediatric and neonatal ICU.
  
  
  METHODS
  Retrospective cohort.
  
  
  METHODS
  Ten-bed pediatric medicosurgical ICU and 15-bed neonatal ICU.
  
  
  METHODS
  Children and newborns undergoing supraclavicular ultrasound-guided subclavian vein catheterization from March 2010 to September 2010.
  
  
  METHODS
  The placement of central venous catheter in ICU was carried out either by one of the experts in ultrasound-guided puncture of the unit or by a novice completely supervised by the expert. The success and the early complications were recorded. A comparison between novice and expert operators was also made.
  
  
  RESULTS
  Forty-two catheters were placed in 40 children. The median age and median weight were, respectively, 6.5 months and 6.5 kg. The success rate was 97.6% (one failure) and the early complication rate was 4.7% (one pneumothorax and one arterial puncture); 61% of children breathed spontaneously during the catheter placement. No significant difference was found between expert and novice operators.
  
  
  CONCLUSIONS
  Supraclavicular ultrasound-guided catheterization of the subclavian vein in pediatric and neonatal ICU seems to be a promising technique in the context of emergency. It is safe, reliable, with few early complications. Furthermore, it does not compromise the airways of the patient owing to the low level of sedation needed for its placement.
authors: Réanimation Médico-Chirurgicale Pédiatrique Spécialisée, Hôpitaux Universitaire de Strasbourg, Strasbourg, France. as_guilbert@hotmail.com
authors: Anne-Sophie
authors: AS
authors: Guilbert
authors: Lorenço
authors: L
authors: Xavier
authors: Clément
authors: C
authors: Ammouche
authors: Philippe
authors: P
authors: Desprez
authors: Dominique
authors: D
authors: Astruc
authors: Pierre
authors: P
authors: Diemunsch
authors: Jocelyne
authors: J
authors: Bientz
mesh_terms: D000293:Adolescent; D001158:Arteries / Q000293:injuries; D002405:Catheterization, Central Venous / Q000009:adverse effects / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D002983:Clinical Competence; D005240:Feasibility Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D011030:Pneumothorax / Q000209:etiology; D012189:Retrospective Studies; D013350:Subclavian Vein; D018084:Ultrasonography, Interventional