title: Ultrasound-guided percutaneous central venous catheterization in infants: Learning curve and related complications.
abstract: BACKGROUND
  This study was performed to evaluate the learning curve and related complications of ultrasound (US) guided central venous catheter (CVC) insertion in infants.
  
  
  METHODS
  This study was performed in Imam Hosein Hospital of Isfahan from September 2014 to March 2015. Participants were infants consecutively candidate for CVC insertion. Three steps were designed to complement the learning. For each step of learning, 20 patients were considered and for every patient one CVC was inserted: (1) In the first step, venous puncture and guide wire passage was performed by an experienced radiologist and the surgeon was taught how to do it, then CVC was placed by the surgeon. (2) In the second step, venous puncture and guide-wire passage was performed by the surgeon under the supervision of the same radiologist, and then CVC was placed by the surgeon. (3) In the third step, US-guided CVC insertion was performed by the surgeon completely, and the radiologist came to the operating room only if it was necessary. In each of these steps, the time spent of the US probe on the skin until the guide wire passage into the vein was recorded for every patient. All perioperative complications were recorded.
  
  
  RESULTS
  The mean point for the time spent of the US probe on the skin until the guide wire passage into the vein was 84.9 ± 13.6, 119.1 ± 15.2, and 90.3 ± 11.2 s in the step 1, 2 and 3, respectively (P = 0.04). There was no significant difference between the frequencies of complications among tree steps.
  
  
  CONCLUSIONS
  US-guided percutaneous CVC insertion is a safe and reliable method which can be easily and rapidly learned.
authors.affiliation: Department of Pediatric Surgery, Imam Hosein Pediatric Hospital, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Omid
authors.affiliation: Department of Pediatric Surgery, Imam Hosein Pediatric Hospital, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Mohammad Hadi
authors.initials: MH
authors.lastname: Rafiei
authors.affiliation: Department of Pediatric Surgery, Imam Hosein Pediatric Hospital, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Mehrdad
authors.initials: M
authors.lastname: Hosseinpour
authors.affiliation: Department of Pediatric Surgery, Imam Hosein Pediatric Hospital, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Mehrdad
authors.initials: M
authors.lastname: Memarzade
authors.affiliation: Department of Radiology, Imam Hosein Pediatric Hospital, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Maryam
authors.initials: M
authors.lastname: Riahinejad
keywords: Learning curve; perioperative complications; ultrasound-guided central venous catheter insertion