title: Ultrasound-guided tunneled lower extremity peripherally inserted central catheter placement in infants.
abstract: Tunneled lower extremity peripherally inserted central catheters (PICCs) are placed in infants under combined ultrasound and fluoroscopic guidance in the interventional radiology suite. In infants requiring a bedside procedure, image guidance is limited, often using portable radiographs during the procedure. This report demonstrates feasibility of placing tunneled lower extremity PICCs using ultrasound as the sole imaging modality for vascular access, intravascular length measurement, and final confirmation of catheter tip position in a case series of 15 critically ill infants. The technique negates the need for added imaging confirmation methods that use ionizing radiation and can be performed at the bedside.
authors.affiliation: Department of Pediatric Radiology, Children's Hospital of Wisconsin, Medical College of Wisconsin, 9000 W Wisconsin Avenue, Milwaukee, WI 53226. Electronic address: drsubbusmc@yahoo.co.in.
authors.forename: Subramanian
authors.initials: S
authors.lastname: Subramanian
authors.forename: David C
authors.initials: DC
authors.lastname: Moe
authors.forename: Jack N
authors.initials: JN
authors.lastname: Vo
mesh_terms: D002405:Catheterization, Central Venous / Q000295:instrumentation; D002406:Catheterization, Peripheral / Q000295:instrumentation; D002408:Catheters, Indwelling; D062905:Central Venous Catheters; D016503:Drug Delivery Systems; D004867:Equipment Design; D005240:Feasibility Studies; D005260:Female; D005268:Femoral Vein / Q000000981:diagnostic imaging*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007262:Infusions, Intravenous; D035002:Lower Extremity / Q000098:blood supply*; D008297:Male; D010289:Parenteral Nutrition, Total; D019095:Point-of-Care Systems; D012189:Retrospective Studies; D018084:Ultrasonography, Interventional; D014682:Vena Cava, Inferior / Q000000981:diagnostic imaging*
keywords: ICU; IVC; PICC; UVC; inferior vena cava; intensive care unit; peripherally inserted central catheter; umbilical venous catheters