Canalización del tronco braquiocefálico guiada por ecografía en neonatos y lactantes

  1. Ignacio Oulego-Erroz 13
  2. Paula Alonso-Quintela 13
  3. Patricia Domínguez 1
  4. Silvia Rodríguez-Blanco 1
  5. Manoel Muñíz-Fontán 1
  6. Ana Muñoz-Lozón 1
  7. Gloria López-Blanco 1
  8. Antonio Rodríguez-Nuñez 2
  1. 1 Servicio de Pediatría, Complejo Asistencial Universitario de León
  2. 2 Servicio de Críticos y Urgencias Pediátricas, Complejo Hospitalario Universitario de Santiago de Compostela
  3. 3 IBIOMED, Instituto de Biomedicina de León
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Zeitschrift:
Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría ( AEP )

ISSN: 1695-4033,  1696-4608

Datum der Publikation: 2016

Ausgabe: 84

Nummer: 6

Seiten: 331-336

Art: Artikel

DOI: 10.1016/J.ANPEDI.2015.03.013 PMID: 25979387 SCOPUS: 2-s2.0-84929093651 DIALNET GOOGLE SCHOLAR lock_openOpen Access editor

Andere Publikationen in: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría ( AEP )

Zusammenfassung

Introduction Central venous catheter (CVC) insertion in neonates and small infants is a challenging and high risk procedure. Ultrasound (US) guided cannulation increases the success rate and reduces procedural-related complications. The internal jugular vein is the most frequent site for US-guided CVC insertion. However this approach is technically demanding in neonates and small infants. US-guided supraclavicular cannulation of the brachiocephalic vein (BCV) is a new approach that may be advantageous in case of difficult central venous catheterization. We present our preliminary experience with this technique in a case series of neonates and small infants. Methods Case series of neonates and small infants weighing less than 5kg, in whom US-guided supraclavicular cannulation of the BCV was attempted. A longitudinal “in plane” supraclavicular approach to the BCV was performed using a 12Hz linear or a 8Hz microconvex transducer. All cannulations were performed by the same operator, a pediatrician with previous experience in US-guided central venous catheterization. Results The study included 6 patients with a median (range) weight of 2.1 (0.94-4.1) kg and age of 1.9 (0.6-4) months. Two cases required 2 punctures, while cannulation was achieved at the first attempt in the remaining 4 cases. There were no procedural or catheter-related complications. CVCs were withdrawn after 9 (6-15) days. Conclusions The US-guided supraclavicular approach to the BCV is a feasible and safe alternative in neonates and very small infants. More studies are needed to define the role of this new venous access before its routine application in daily practice.

Bibliographische Referenzen

  • A.S. Guilbert, L. Xavier, C. Ammouche, P. Desprez, D. Astruc, P. Diemunsch, and et al. Supraclavicular ultrasound-guided catheterization of the subclavian vein in pediatric and neonatal ICUs: A feasibility study Pediatr Crit Care Med. 14 2013 351 355
  • C. Breschan, M. Platzer, R. Jost, H. Stettner, A.S. Beyer, G. Feigl, and et al. Consecutive, prospective case series of a new method for ultrasound-guided supraclavicular approach to the brachiocephalic vein in children Br J Anaesth 106 2011 732 737
  • C. Breschan, M. Platzer, R. Jost, H. Stettner, G. Feigl, and R. Likar Ultrasound-guided supraclavicular cannulation of the brachiocephalic vein in infants: A retrospective analysis of a case series Paediatr Anaesth 22 2012 1062 1067
  • C. Rey, F. Alvarez, V. de la Rua, A. Medina, A. Concha, J.J. Díaz, and et al. Mechanical complications during central venous cannulations in pediatric patients Intensive Care Med. 35 2009 1438 1443
  • C.D. Froehlich, M.R. Rigby, E.S. Rosenberg, R. Li, P.L. Roerig, K.A. Easley, and et al. Ultrasound-guided central venous catheter placement decreases complications and decreases placement attempts compared with the landmark technique in patients in a pediatric intensive care unit Crit Care Med. 37 2009 1090 1096
  • H.J. Byon, G.W. Lee, J.H. Lee, Y.H. Park, H.S. Kim, C.S. Kim, and et al. Comparison between ultrasound-guided supraclavicular and infraclavicular approaches for subclavian venous catheterization in children - a randomized trial Br J Anaesth. 111 2013 788 792
  • I.P. Latto, W.S. Ng, P.L. Jones, and B.J. Jenkins Percutaneous central venous & arterial catheterization 3rd ed 2000 W.B. Saunders
  • J.M. Costello, T.C. Clapper, and D. Wypij Minimizing complications associated with percutaneous central venous catheter placement in children: Recent advances Pediatr Crit Care Med 14 2013 273 283
  • M. Di Nardo, C. Tomasello, M. Pittiruti, D. Perrotta, M. Marano, C. Cecchetti, and et al. Ultrasound-guided central venous cannulation in infants weighing less than 5 kilograms J Vasc Access. 12 2011 321 324
  • M. Di Nardo, F. Stoppa, M. Marano, Z. Ricci, M.A. Barbieri, and C. Cecchetti Ultrasound-guided left brachiocephalic vein cannulation in children with underlying bleeding disorders: A retrospective analysis Pediatr Crit Care Med. 15 2014 e44 e48
  • M. Lamperti, A.R. Bodenham, M. Pittiruti, M. Blaivas, J.G. Augoustides, M. Elbarbary, and et al. International evidence-based recommendations on ultrasound-guided vascular access Intensive Care Med. 38 2012 1105 1117
  • M. Lamperti, N. Moureau, L.J. Kelly, R. Dawson, M. Elbarbary, A.J. van Boxtel, and et al. Competence in paediatric central venous lines placement Br J Anaesth. 112 2014 383
  • M. Lamperti, P. Cortellazzi, and D. Caldiroli Ultrasound-guided cannulation of IJV in pediatric patients: Are meta-analyses sufficient Paediatr Anaesth. 20 2010 373 374
  • M. Lennon, N.N. Zaw, D.M. Pöpping, and M. Wenk Procedural complications of central venous catheter insertion Minerva Anestesiol. 78 2012 1234 1240
  • M. Pittiruti Ultrasound guided central vascular access in neonates, infants and children Curr Drug Targets. 13 2012 961 969
  • M. Tailounie, L.A. Mcadams, K.C. Frost, J. Gossett, J. Green, A.T. Bhutta, and et al. Dimension and overlap of femoral and neck blood vessels in neonates Pediatr Crit Care Med. 13 2012 312 317
  • N. Moureau, M. Lamperti, L.J. Kelly, R. Dawson, M. Elbarbary, A.J. van Boxtel, and et al. Evidence-based consensus on the insertion of central venous access devices: Definition of minimal requirements for training Br J Anaesth. 110 2013 347 356
  • O. Rhondali, R. Attof, S. Combet, D. Chassard, and M. de Queiroz Siqueira Ultrasound-guided subclavian vein cannulation in infants: Supraclavicular approach Paediatr Anaesth. 21 2011 1136 1141
  • P. Brass, M. Hellmich, L. Kolodziej, G. Schick, and A.F. Smith Ultrasound guidance versus anatomical landmarks for subclavian or femoral vein catheterization Cochrane Database Syst Rev. 1 2015 CD011447
  • P. Brass, M. Hellmich, L. Kolodziej, G. Schick, and A.F. Smith Ultrasound guidance versus anatomical landmarks for internal jugular vein catheterization Cochrane Database Syst Rev. 1 2015 CD006962
  • S. Iwashima, T. Ishikawa, and T. Ohzeki Ultrasound-guided versus landmark-guided femoral vein access in pediatric cardiac catheterization Pediatr Cardiol 29 2008 339 342
  • S. Sigaut, A. Skhiri, I. Stany, J. Golmar, Y. Nivoche, I. Constant, and et al. Ultrasound guided internal jugular vein access in children and infant: A meta-analysis of published studies Paediatr Anaesth. 19 2009 1199 1206
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