Halil Keskin1, Filiz Keskin2, Pelin Aydin3, Muhammet Akif Guler4, Ali Ahiskalioglu5. 1. Department of Pediatric Intensive Care Unit, Ataturk University School of Medicine, Erzurum, Turkey; Clinical Research, Development and Design Application and Research Center, Ataturk University School of Medicine, Erzurum, Turkey. Electronic address: keskinpediatrize@gmail.com. 2. Department of Pediatric Neurology, Ataturk University School of Medicine, Erzurum, Turkey. 3. Department of Anesthesiology and Reanimation, Erzurum State Hospital, Erzurum, Turkey. 4. Department of Pediatric Nephrology, Ataturk University School of Medicine, Erzurum, Turkey. 5. Clinical Research, Development and Design Application and Research Center, Ataturk University School of Medicine, Erzurum, Turkey; Department of Anesthesiology and Reanimation, Ataturk University School of Medicine, Erzurum, Turkey.
Abstract
OBJECTIVE: Although pediatric central venous catheterization is performed using ultrasound guidance, it is still a challenge. This study aimed to investigate the efficacy of the syringe-free, long-axis in-plane approach and compared the short-axis classic out-of-plane approach for ultrasound-guided central venous catheter placement in critically ill pediatric patients. DESIGN: Prospective randomized study. SETTING:Single institution, tertiary university hospital, pediatric care unit. PARTICIPANTS: The study comprised 60 patients ages three months to 15 years. INTERVENTIONS: Participants were randomly divided into two equal groups. Group I (n = 30) incorporated patients who underwent the long-axis, syringe-free in-plane approach, and group II (n = 30) incorporated patients who underwent the short-axis out-of-plane approach. MEASUREMENTS AND MAIN RESULTS:Performing time, number of needle passes, number of skin punctures, first-pass success rate, and related complications were evaluated. There were no differences between the two groups in terms of demographics and vein-related measurements (p > 0.05). Performing time was statistically shorter in group I compared with group II (32 [25-38] v 58 [42-70] s; p < 0.001). There was no statistical difference between first-pass success rates between groups (group I 86.6% v group II 80%; p = 0.731). There were no significant differences between the groups in the number of needle passes and skin punctures (p = 0.219 and 0.508, respectively). Complications occurred in both groups, but there was no significant difference (4/30 v 7/30; p = 0.317). CONCLUSIONS: The syringe-free, long-axis in-plane approach can be a safe and fast alternative for pediatric catheterization.
RCT Entities:
OBJECTIVE: Although pediatric central venous catheterization is performed using ultrasound guidance, it is still a challenge. This study aimed to investigate the efficacy of the syringe-free, long-axis in-plane approach and compared the short-axis classic out-of-plane approach for ultrasound-guided central venous catheter placement in critically ill pediatric patients. DESIGN: Prospective randomized study. SETTING: Single institution, tertiary university hospital, pediatric care unit. PARTICIPANTS: The study comprised 60 patients ages three months to 15 years. INTERVENTIONS:Participants were randomly divided into two equal groups. Group I (n = 30) incorporated patients who underwent the long-axis, syringe-free in-plane approach, and group II (n = 30) incorporated patients who underwent the short-axis out-of-plane approach. MEASUREMENTS AND MAIN RESULTS: Performing time, number of needle passes, number of skin punctures, first-pass success rate, and related complications were evaluated. There were no differences between the two groups in terms of demographics and vein-related measurements (p > 0.05). Performing time was statistically shorter in group I compared with group II (32 [25-38] v 58 [42-70] s; p < 0.001). There was no statistical difference between first-pass success rates between groups (group I 86.6% v group II 80%; p = 0.731). There were no significant differences between the groups in the number of needle passes and skin punctures (p = 0.219 and 0.508, respectively). Complications occurred in both groups, but there was no significant difference (4/30 v 7/30; p = 0.317). CONCLUSIONS: The syringe-free, long-axis in-plane approach can be a safe and fast alternative for pediatric catheterization.