학술논문

Feasibility of the ultrasound‐guided supraclavicular cannulation of the brachiocephalic vein in very small weight infants: A case series.
Document Type
Article
Source
Pediatric Anesthesia. Aug2020, Vol. 30 Issue 8, p928-933. 6p.
Subject
*BRACHIOCEPHALIC veins
*WEIGHT in infancy
*CATHETERIZATION
*IMPLANTABLE catheters
*CATHETERS
Language
ISSN
1155-5645
Abstract
Background: The aim of this retrospective analysis was to evaluate the clinical feasibility of the supraclavicular ultrasound‐guided cannulation of the brachiocephalic vein in infants weighing less than 1500 g. Methods: The ultrasound probe was placed in the supraclavicular region so as to obtain the optimum sonographic long‐axis view of the brachiocephalic vein. By using an in‐plane approach the brachiocephalic vein was cannulated by using a 24‐gauge intravenous cannula under real‐time ultrasound guidance into the vein followed by the insertion of a 2‐French single lumen catheter using the Seldinger technique. Results: Forty‐six brachiocephalic vein cannulations in infants weighing between 0.55 and 1.5 kg (Median: 1.2; 95%‐CI: 0.9‐1.2) were included. Ultimate success rate was 89.1% (41 out of 46). One cannulation attempt was required in 30 (65.2%) patients, 2 in 6 (13%) and 3 in 5 (10.8%), respectively. Smaller weight babies did not require significantly more cannulation attempts. The probability of successful cannulation on the first attempt increased significantly from 40% (2010) to more than 80% (2019) over the time course of this series. Median catheter dwell time was 15 days (95%‐CI: 9‐20) with one catheter being removed prematurely after 8 days due to obstruction. Conclusion: Supracalvicular in‐plane real‐time ultrasound‐guided cannulation of the brachiocephalic vein seems to be a convenient and feasible option to provide large‐bore central venous access for very small and sick babies. [ABSTRACT FROM AUTHOR]