Objective
Although pediatric central venous catheterization is performed using ultrasound guidance,
it is still a challenge. This study aimed to investigate the efficacy of the syringe-free,
long-axis in-plane approach and compared the short-axis classic out-of-plane approach
for ultrasound-guided central venous catheter placement in critically ill pediatric
patients.
Design
Prospective randomized study.
Setting
Single institution, tertiary university hospital, pediatric care unit.
Participants
The study comprised 60 patients ages three months to 15 years.
Interventions
Participants were randomly divided into two equal groups. Group I (n = 30) incorporated
patients who underwent the long-axis, syringe-free in-plane approach, and group II
(n = 30) incorporated patients who underwent the short-axis out-of-plane approach.
Measurements and Main Results
Performing time, number of needle passes, number of skin punctures, first-pass success
rate, and related complications were evaluated. There were no differences between
the two groups in terms of demographics and vein-related measurements (p > 0.05).
Performing time was statistically shorter in group I compared with group II (32 [25-38]
v 58 [42-70] s; p < 0.001). There was no statistical difference between first-pass
success rates between groups (group I 86.6% v group II 80%; p = 0.731). There were no significant differences between the groups
in the number of needle passes and skin punctures (p = 0.219 and 0.508, respectively).
Complications occurred in both groups, but there was no significant difference (4/30
v 7/30; p = 0.317).
Conclusions
The syringe-free, long-axis in-plane approach can be a safe and fast alternative for
pediatric catheterization.
Key Words
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Article info
Publication history
Published online: March 25, 2021
Identification
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