Central Venous Catheter Cannulation in Pediatric Anesthesia and Intensive Care: A Prospective Observational Trial
Abstract
:1. Introduction
2. Materials and Methods
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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US-Guided (n = 52) | Landmark (n = 55) | |||
---|---|---|---|---|
Mean (SD) | Median (Min–Max) | Mean (SD) | Median (Min–Max) | |
Age (years) | 6.6 | 7.1 | 4.1 | 0.3 |
(5.9) | (0.0–17.7) | (5.9) | (0.0–17.5) | |
Height (cm) | 108 | 121 | 86 | 60 |
(48) | (34–186) | (48) | (33–180) | |
Weight (kg) | 26 | 22 | 18 | 5 |
(22) | (1–82) | (22) | (1–71) |
Category | US-Guided (n = 52) | Landmark (n = 55) | p-Value | |
---|---|---|---|---|
n (%) | n (%) | |||
Indication | Long-term I.V. access Parenteral nutrition Catecholamine’s Infusion therapy Antibiotics | 28 (53.8%) 20 (38.5%) 2 (3.8%) 2 (3.8%) 0 (0.0%) | 27 (49.1%) 24 (43.6%) 2 (3.6%) 1 (1.8%) 1 (1.8%) | 0.909 |
Planned insertion site | Vena subclavia l. sin. Vena subclavia l. dx. Vena brachiocephalica l. sin. Vena brachiocephalica l. dx. Vena jugularis interna l. sin. Vena jugularis interna l. dx. Vena femoralis l. sin. Vena femoralis l. dx. | 2 (3.8%) 0 (0.0%) 29 (55.8%) 7 (13.5%) 2 (3.8%) 10 (19.2%) 1 (1.9%) 1 (1.9%) | 50 (90.9%) 5 (9.1%) 0 (0.0%) 0 (0.0%) 0 (0.0%) 0 (0.0%) 0 (0.0%) 0 (0.0%) | <0.001 |
Type of anesthesia | General anesthesia | 51 (98.1%) | 53 (96.4%) | 1.000 |
Sedation | 1 (1.9%) | 2 (3.6%) |
Category | US-Guided (n = 52) | Landmark (n = 55) | p-Value | |
---|---|---|---|---|
n (%) | n (%) | |||
Success cannulation | Yes No | 52 (100%) 0 (0.00%) | 53 (96.4%) 2 (3.6%) | 0.496 |
Number of necessary attempts (necessary skin puncture) | 1 2 3 4 More than 5 | 30 (57.7%) 11 (21.2%) 4 (7.7%) 2 (3.8%) 0 (0.0%) | 25 (45.5%) 12 (21.8%) 3 (5.5%) 6 (10.9%) 9 (16.4%) | 0.460 |
Final insertion site | Vena subclavia l. sin. Vena subclavia l. dx. Vena brachiocephalica l. sin. Vena brachiocephalica l. dx. Vena jugularis interna l. sin. Vena jugularis interna l. dx. Vena femoralis l. sin. Vena femoralis l. dx. | 9 (17.3%) 2 (3.8%) 26 (50.0%) 3 (5.8%) 1 (1.9%) 8 (15.4%) 1 (1.9%) 1 (1.9%) | 49 (89.1%) 5 (9.1%) 1 (1.8%) 0 (0.0%) 0 (0.0%) 0 (0.0%) 0 (0.0%) 0 (0.0%) | <0.001 |
Catheter size (Fr) | 1.0 3.0 4.0 5.0 5.5 7.0 9.0 12.0 | 1 (1.9%) 4 (7.7%) 11 (21.2%) 9 (17.3%) 4 (7.7%) 21 (40.4%) 1 (1.9%) 1 (1.9%) | 0 (0.0%) 15 (27.3%) 16 (29.1%) 8 (14.5%) 4 (7.3%) 12 (21.8%) 0 (0.0%) 0 (0.0%) | 0.042 |
No of lumens | 2 | 32 (61.5%) | 43 (78.2%) | 0.090 |
3 or more | 20 (38.5%) | 12 (21.8%) | ||
No of operators | 1 2 | 28 (53.8%) 24 (46.2%) | 40 (72.7%) 15 (27.3%) | 0.047 |
Years of practice | 0–5 5–10 10 and more | 28 (53.8%) 12 (23.1%) 12 (23.1%) | 31 (56.4%) 4 (7.3%) 20 (36.3%) | 0.048 |
US-Guided (n = 52) | Landmark (n = 55) | p-value | |||
---|---|---|---|---|---|
Mean (SD) | Median (Min-Max) | Mean (SD) | Median (Min-Max) | ||
Depth of insertion (cm) | 10.6 | 10.5 | 9.2 | 8.0 | 0.031 |
(3.6) | (5.0–18.0) | (3.6) | (5.0–17.0) | ||
Time of insertion (min) | 19.3 (11.9) | 15,1 (2.0–50.0) | 14.5 (7.9) | 15.0 (2.7–42.0) | 0.085 |
Category | US-Guided (n = 52) | Landmark (n = 55) | p-Value | |
---|---|---|---|---|
n (%) | n (%) | |||
Artificial punction of artery | No Yes | 48 (92.3%) 4 (7.7%) | 53 (96.4%) 2 (3.6%) | 0.429 |
Insertion of guidewire (No. of attempts) | 1st 2nd 3rd or more | 36 (69.2%) 11 (21.2%) 5 (9.6%) | 48 (87.3%) 5 (9.1%) 2 (3.6%) | 0.075 |
Periprocedural X-ray control | No | 3 (5.8%) | 3 (5.5%) | 1.000 |
Yes | 49 (94.2%) | 52 (94.5%) | ||
X-ray control and possible malposition | No Yes–no malposition Yes–malposition | 7 (13.5%) 37 (71.2%) 8 (15.4%) | 3 (5.5%) 47 (85.5%) 5 (9.1%) | 0.222 |
Pneumothorax | No control Control–PNO Control–no PNO | 7 (13.5%) 44 (84.6%) 1 (1.9%) | 2 (3.6%) 52 (94.5%) 1 (1.8%) | 0.125 |
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Vafek, V.; Skříšovská, T.; Kosinová, M.; Klabusayová, E.; Musilová, T.; Kramplová, T.; Djakow, J.; Klučka, J.; Kalina, J.; Štourač, P. Central Venous Catheter Cannulation in Pediatric Anesthesia and Intensive Care: A Prospective Observational Trial. Children 2022, 9, 1611. https://doi.org/10.3390/children9111611
Vafek V, Skříšovská T, Kosinová M, Klabusayová E, Musilová T, Kramplová T, Djakow J, Klučka J, Kalina J, Štourač P. Central Venous Catheter Cannulation in Pediatric Anesthesia and Intensive Care: A Prospective Observational Trial. Children. 2022; 9(11):1611. https://doi.org/10.3390/children9111611
Chicago/Turabian StyleVafek, Václav, Tamara Skříšovská, Martina Kosinová, Eva Klabusayová, Tereza Musilová, Tereza Kramplová, Jana Djakow, Jozef Klučka, Jiří Kalina, and Petr Štourač. 2022. "Central Venous Catheter Cannulation in Pediatric Anesthesia and Intensive Care: A Prospective Observational Trial" Children 9, no. 11: 1611. https://doi.org/10.3390/children9111611
APA StyleVafek, V., Skříšovská, T., Kosinová, M., Klabusayová, E., Musilová, T., Kramplová, T., Djakow, J., Klučka, J., Kalina, J., & Štourač, P. (2022). Central Venous Catheter Cannulation in Pediatric Anesthesia and Intensive Care: A Prospective Observational Trial. Children, 9(11), 1611. https://doi.org/10.3390/children9111611