Volume 15 Supplement 1

31st International Symposium on Intensive Care and Emergency Medicine

Open Access

Real-time ultrasound guidance for internal jugular vein catheterization in neonates: preliminary experience

  • M Di Nardo1,
  • F Stoppa1,
  • C Tomasello1,
  • C Cecchetti1,
  • M Marano1,
  • D Perrotta1,
  • E Pasotti1 and
  • N Pirozzi1
Critical Care201115(Suppl 1):P23

https://doi.org/10.1186/cc9443

Published: 1 March 2011

Introduction

Recent studies reported that real-time ultrasound guidance for internal jugular vein catheterization is useful in infants. However, this technique is sometimes difficult even for skilled physicians. The aim of our study is therefore to evaluate the success rate and the complication rate of this technique performed by ultrasound-trained pediatric intensivists in neonates.

Methods

Fifteen consecutive term neonates (mean weight 3.9 ± 1.1 kg) needing a central venous access for intensive care treatment were prospectively studied for ultrasound-guided internal jugular vein cannulation. Patients' age, weight, time for cannulation, catheter size, central venous time permanence, success rate and complications rate were recorded.

Results

Cannulation was successful in all 15 infants. The right internal jugular vein was used in 90% of the patients enrolled, while in the remaining 10% the left internal jugular vein was used. The overall complication rate was 22%. We had only one major complication (2%): lung pneumothorax. Minor complications were: multiple skin and vein punctures (9%), Seldinger wire kinking (7%) and venous hematomas (4%). Time required for complete cannulation was 8 ± 4.3 minutes, while the mean duration of the central venous catheter was 5 ± 5 days.

Conclusions

Our results suggest that ultrasound assistance for central vein cannulation can be easily performed by well-trained physicians in neonates. Particular solutions (increase of the tilting angle of the bed, use of soft nitilon tip guide wire and the transfixation technique) can be sometimes requested to increase the success rate of our procedures. In accordance to these considerations, US-guided CVC placement should be probably considered as the first choice method for catheterization in infants.

Authors’ Affiliations

(1)
Ospedale Pediatrico Bambino Gesù

References

  1. Verghese S, McGill W, Patel R, Norden J, Ruttiman U: Internal jugular vein cannulation in infants: palpation vs imaging. Anestesiology 1996, 85: 1078.Google Scholar
  2. Leyvi G, Taylor D, Reith E, Wasnick J: Utility of ultrasound-guided central venous cannulation in pediatric surgical patients: a clinical series. Pediatr Anesth 2005, 15: 953-958.View ArticleGoogle Scholar

Copyright

© Di Nardo et al. 2011

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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