Current use of ultrasound for central vascular access in children

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“US was commonly used for cannulation of the internal jugular vein but infrequently for the subclavian vein. A lack of training seems to be a barrier for further increasing the use of US” Olsen et al (2015).

Reference:

Olsen, T.C., Rimstad, I.J., Tarpgaard, M., Holmberg, S. and Hallas, P. (2015) Current use of ultrasound for central vascular access in children and infants in the Nordic countries – a cross-sectional study. The Journal of Vascular Access. January 17th. [epub ahead of print].

Abstract:

PURPOSE: The use of ultrasound (US) guidance for central vascular access in children has been advocated as a safer approach compared to traditional landmark techniques. We therefore collected data on the current use of US for central vascular access in children and infants in the Nordic countries.

METHODS: A cross-sectional survey using an online questionnaire was distributed to one anaesthesiologist at every hospital in the Nordic countries; a total of 177 anaesthesiologists were contacted from July till August 2012.

RESULTS: The use of US for placing central venous catheters (CVCs) seems widespread across the Nordic countries. Close to 80% of respondents were using it “almost always” or “frequently” across all paediatric age groups for internal jugular vein cannulation. US was least frequently used when catheterizing the subclavian vein. The two most common reasons given when not using US were lack of training followed by lack of equipment. We found no difference in the use of US between high-volume centres and low-volume centres. (High-volume centres placed paediatric CVCs at least weekly.).

CONCLUSIONS: US was commonly used for cannulation of the internal jugular vein but infrequently for the subclavian vein. A lack of training seems to be a barrier for further increasing the use of US. Establishing standardized training programmes based on current evidence should alleviate this.

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