Ultrasound guided central venous catheter placement in pediatric patients

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Literature regarding US-guided CVC placement in children remains limited and conflicting. This meta-analysis examines the efficacy and safety of US-guided CVC placement among pediatric patients” Lau and Chamberlain (2016).

Abstract:

BACKGROUND: Real-time ultrasound (US) guidance for central venous catheter (CVC) insertion has been shown to increase cannulation success rates and reduce complications in adults. Literature regarding US-guided CVC placement in children remains limited and conflicting. This meta-analysis examines the efficacy and safety of US-guided CVC placement among pediatric patients.

METHODS: A comprehensive literature search of all published randomized control trials (RCTs) comparing the use of real-time US-guided CVC insertion with anatomic landmark (LM) guided CVC insertion in pediatric patients

RESULTS: 8 RCTs involving 760 patients were analyzed. US-guided CVC insertion significantly increased success rates by 31.8% and decreased the mean number of attempts required. A trend towards a decrease in the risk of accidental arterial puncture with the use of US-guided CVC insertion was also observed. US-guided CVC insertion was not associated with a significant difference in time required for CVC placement.

CONCLUSION: US-guided CVC placement is associated with significantly higher success rates and decreased mean number of attempts required for cannulation. US-guided CVC insertion improves success rates, and should be utilized in pediatric patients.

Reference:

Lau, C.S. and Chamberlain, R.S. (2016) Ultrasound Guided Central Venous Catheter Placement Increases Success Rates in Pediatric Patients: A Meta-Analysis. Pediatric Research. April 8th. [Epub ahead of print].

doi: 10.1038/pr.2016.74.

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