Ultrasound-guided cannulation of the brachiocephalic vein in neonates

0

Reference:

Oulego-Erroz, I., Alonso-Quintela, P., Domínguez, P., Rodríguez-Blanco, S., Muñíz-Fontán, M., Muñoz-Lozón, A., López-Blanco, G. and Rodríguez-Nuñez, A. (2015) Ultrasound-guided cannulation of the brachiocephalic vein in neonates and infants. Anales de Pediatría. May 12th. [epub ahead of print]. [Article in Spanish].

Abstract:

INTRODUCTION: Central venous catheter (CVC) insertion in neonates and small infants is a challenging and high risk procedure. Ultrasound (US) guided cannulation increases the success rate and reduces procedural-related complications. The internal jugular vein is the most frequent site for US-guided CVC insertion. However this approach is technically demanding in neonates and small infants. US-guided supraclavicular cannulation of the brachiocephalic vein (BCV) is a new approach that may be advantageous in case of difficult central venous catheterization. We present our preliminary experience with this technique in a case series of neonates and small infants.

METHODS: Case series of neonates and small infants weighing less than 5kg, in whom US-guided supraclavicular cannulation of the BCV was attempted. A longitudinal “in plane” supraclavicular approach to the BCV was performed using a 12Hz linear or a 8Hz microconvex transducer. All cannulations were performed by the same operator, a pediatrician with previous experience in US-guided central venous catheterization.

RESULTS: The study included 6 patients with a median (range) weight of 2.1 (0.94-4.1) kg and age of 1.9 (0.6-4) months. Two cases required 2 punctures, while cannulation was achieved at the first attempt in the remaining 4 cases. There were no procedural or catheter-related complications. CVCs were withdrawn after 9 (6-15) days.

CONCLUSIONS: The US-guided supraclavicular approach to the BCV is a feasible and safe alternative in neonates and very small infants. More studies are needed to define the role of this new venous access before its routine application in daily practice.

Thank you to our partners for supporting IVTEAM

Share.

Comments are closed.

Free Email Updates
Join 5.5K IVTEAM members. Subscribe now and be the first to receive all the latest free updates from IVTEAM!
100% Privacy. We don't spam.