Nicolas Nardi1, Eric Wodey2, Bruno Laviolle3, François De La Brière4, Séverine Delahaye4, Charlotte Engrand4, Cécile Gauvrit4, Sabrina Dessard4, Anne Defontaine4, Claude Ecoffey5. 1. Service d'anesthésie-réanimation 2, CHU de Rennes, 35203 Rennes, France; Université de Rennes 1, 35000 Rennes, France; UMR Inserm 1099, LTSI, université de Rennes 1, 35043 Rennes, France. Electronic address: nicolas.nardi@chu-rennes.fr. 2. Service d'anesthésie-réanimation 2, CHU de Rennes, 35203 Rennes, France; Université de Rennes 1, 35000 Rennes, France; UMR Inserm 1099, LTSI, université de Rennes 1, 35043 Rennes, France. 3. Université de Rennes 1, 35000 Rennes, France; Service de pharmacologie, centre d'investigation clinique, CHU de Rennes, 35000 Rennes, France. 4. Service d'anesthésie-réanimation 2, CHU de Rennes, 35203 Rennes, France. 5. Service d'anesthésie-réanimation 2, CHU de Rennes, 35203 Rennes, France; Université de Rennes 1, 35000 Rennes, France.
Abstract
BACKGROUND: The ultrasound (US)-guided supraclavicular approach to subclavian vein (Sup-SCV) catheterisation in children has recently been described and evaluated in a small cohort. The aim of this study was to assess this technique in a large paediatric cohort including neonates. METHODS: We conducted a prospective observational study between November 2010 and December 2013 which included 615 children divided into two groups according to their weight: Group 1≤5kg (n=124), Group 2>5kg (n=491). All procedures were performed under general anaesthesia by an anaesthesiologist or a supervised resident. The success rates of catheter insertion, the number of punctures required, the procedure time, and the complication rates were analysed. RESULTS: Sup-SCV catheterisation was successful in 98% of the cases and was higher in Group 2 than in Group 1 (99.4% versus 92.7%, P<0.001). The success rate after the first attempt was higher and the incidence of multiple attempts (≥3 punctures) was lower in Group 2 than in Group 1 (84.2% versus 64.5%, P<0.001 and 4.5% versus 19.4%, P<0.001). The success rate was similar between right and left cannulations (P=0.404), and according to physician experience (P=1.000). Procedure time was fast in both groups with a median time for all procedures of 40 seconds [30-90]. Among the procedures recorded, only five arterial punctures and no cases of pneumothorax were observed. CONCLUSION: US-guided Sup-SCV catheterisation appears to be fast and safe in children and neonates, even if it remains a little more difficult to achieve in lower-weight patients.
BACKGROUND: The ultrasound (US)-guided supraclavicular approach to subclavian vein (Sup-SCV) catheterisation in children has recently been described and evaluated in a small cohort. The aim of this study was to assess this technique in a large paediatric cohort including neonates. METHODS: We conducted a prospective observational study between November 2010 and December 2013 which included 615 children divided into two groups according to their weight: Group 1≤5kg (n=124), Group 2>5kg (n=491). All procedures were performed under general anaesthesia by an anaesthesiologist or a supervised resident. The success rates of catheter insertion, the number of punctures required, the procedure time, and the complication rates were analysed. RESULTS: Sup-SCV catheterisation was successful in 98% of the cases and was higher in Group 2 than in Group 1 (99.4% versus 92.7%, P<0.001). The success rate after the first attempt was higher and the incidence of multiple attempts (≥3 punctures) was lower in Group 2 than in Group 1 (84.2% versus 64.5%, P<0.001 and 4.5% versus 19.4%, P<0.001). The success rate was similar between right and left cannulations (P=0.404), and according to physician experience (P=1.000). Procedure time was fast in both groups with a median time for all procedures of 40 seconds [30-90]. Among the procedures recorded, only five arterial punctures and no cases of pneumothorax were observed. CONCLUSION: US-guided Sup-SCV catheterisation appears to be fast and safe in children and neonates, even if it remains a little more difficult to achieve in lower-weight patients.
Authors: Zied Merchaoui; Ulrik Lausten-Thomsen; Florence Pierre; Maher Ben Laiba; Nolwenn Le Saché; Pierre Tissieres Journal: Front Pediatr Date: 2017-10-05 Impact factor: 3.418
Authors: Yogen Singh; Cecile Tissot; María V Fraga; Nadya Yousef; Rafael Gonzalez Cortes; Jorge Lopez; Joan Sanchez-de-Toledo; Joe Brierley; Juan Mayordomo Colunga; Dusan Raffaj; Eduardo Da Cruz; Philippe Durand; Peter Kenderessy; Hans-Joerg Lang; Akira Nishisaki; Martin C Kneyber; Pierre Tissieres; Thomas W Conlon; Daniele De Luca Journal: Crit Care Date: 2020-02-24 Impact factor: 9.097