Objectives
Ultrasound is currently utilized to locate the internal jugular vein (IJV), reduce
the complications of catheter placement, and increase the likelihood of accessing
IJV. Therefore, the aim of the present study was to evaluate the effectiveness of
ultrasound in reducing complications during catheter placement in children weighing
less than 5 kg.
Materials and methods
The current randomized clinical trial was performed on 111 children weighing less
than 5 kg who required a central venous catheter (CVC). Children were divided into
two groups: in the first group (Seldinger group; n = 55), a CVC was inserted using the Seldinger wire method under ultrasound guidance,
and in the second group (open surgical cutdown (OSC); n = 56), the catheter was inserted via the open method. Two weeks after catheter placement,
patients were evaluated for thrombosis, catheter occlusion, catheter tip migration,
infection, catheter removal, and catheter dysfunction.
Results
The success rate of catheter placement in the ultrasound-guided method was 85.5%.
The incidence of thrombosis (3.6% vs. 5.4%), infection (1.8% vs. 7.4%), and bleeding
(zero vs. 3.6%) was lower in the Seldinger group, but the difference was not significant
(p ˃ 0.05). Hematoma (7.3% vs. 3.6%) occurred less frequently in the patients of the
OSC group (p = 0.33). Hemothorax, pneumothorax, catheter migration, and occlusion did not occur
in any of the patients. In the OSC group, two deaths (3.6%) occurred due to underlying
diseases.
Conclusion
When ultrasound is used to insert a CVC in children weighing less than 5 kg, the incidence
of complications is not significantly different compared to when the open method is
employed.
Key Words
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Article info
Publication history
Published online: November 26, 2022
Accepted:
October 9,
2022
Received in revised form:
September 25,
2022
Received:
July 4,
2022
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2022 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.
