Gabriela Ruschel Zanolla1, Matteo Baldisserotto2, Jefferson Piva3. 1. Universidade Federal de Santa Maria (UFSM), Hospital Universitário de Santa Maria, 97105-340, Av. Roraima, 1000, Prédio 22, Santa Maria, RS, Brazil. Electronic address: gabizanolla@gmail.com. 2. School of Medicine, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), 90619-900, Av. Ipiranga, 6681, Porto Alegre, RS, Brazil; Department of Radiology, Center for Molecular Imaging, PUCRS Brain Institute, 90619-900, Av. Ipiranga, 6681, Porto Alegre, RS, Brazil. Electronic address: matteob@terrra.com.br. 3. School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), 90035-903, Rua Ramiro Barcelos, 2350, Porto Alegre, RS, Brazil; Pediatric Emergency and Intensive Care Department, Hospital de Clínicas de Porto Alegre (HCPA), 90035-903, Rua Ramiro Barcelos, 2350, Porto Alegre, RS, Brazil. Electronic address: jpiva@hcpa.edu.br.
Abstract
PURPOSE: The aim of this study was to determine whether US reduces number of puncture attempts, procedure time, and complication rate during IJV access in children. METHODS: A prospective study was performed in children (age ≤18years) admitted to our institution, from September 2013 to July 2014, with indications for central venous access. Patients meeting the inclusion criteria were randomized to the US-guided or control groups. The same physician performed all IJV cannulations in both groups. The end-points for comparison were: length of time to venous access, number of attempts, and rate of complications. RESULTS:Fifty-one patients were included: 23 in the US-guided group and 28 in the control group. There were no between-group differences in weight, age, or sex. In the US-guided group, the number of punctures needed to achieve IJV access (median [interquartile range], 3 [2-5] vs. 1 [1, 2]; P<0.001), time to achievement of venous access, and complication rate (39% vs. 4.3%, P<0.009) were significantly lower. CONCLUSION: US guidance is a useful adjunct to central venous access in children, facilitating the procedure, decreasing time to cannulation, and increasing safety. TYPE OF STUDY: Prospective randomized study. LEVEL OF EVIDENCE: 1.
RCT Entities:
PURPOSE: The aim of this study was to determine whether US reduces number of puncture attempts, procedure time, and complication rate during IJV access in children. METHODS: A prospective study was performed in children (age ≤18years) admitted to our institution, from September 2013 to July 2014, with indications for central venous access. Patients meeting the inclusion criteria were randomized to the US-guided or control groups. The same physician performed all IJV cannulations in both groups. The end-points for comparison were: length of time to venous access, number of attempts, and rate of complications. RESULTS: Fifty-one patients were included: 23 in the US-guided group and 28 in the control group. There were no between-group differences in weight, age, or sex. In the US-guided group, the number of punctures needed to achieve IJV access (median [interquartile range], 3 [2-5] vs. 1 [1, 2]; P<0.001), time to achievement of venous access, and complication rate (39% vs. 4.3%, P<0.009) were significantly lower. CONCLUSION: US guidance is a useful adjunct to central venous access in children, facilitating the procedure, decreasing time to cannulation, and increasing safety. TYPE OF STUDY: Prospective randomized study. LEVEL OF EVIDENCE: 1.
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