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.
Department of Pediatric Neurology, Ataturk University School of Medicine, Erzurum, Turkey.
J Cardiothorac Vasc Anesth. 2021 Jul;35(7):2094-2099. doi: 10.1053/j.jvca.2021.03.029. Epub 2021 Mar 26.
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.
Prospective randomized study.
Single institution, tertiary university hospital, pediatric care unit.
The study comprised 60 patients ages three months to 15 years.
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.
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).
The syringe-free, long-axis in-plane approach can be a safe and fast alternative for pediatric catheterization.
尽管儿科中心静脉置管术采用超声引导，但这仍然具有挑战性。本研究旨在探讨无针、长轴平面内入路的效果，并比较超声引导下危重症儿科患者中心静脉置管时短轴经典的平面外入路。
前瞻性随机研究。
单机构，三级大学医院，儿科护理病房。
本研究纳入了 3 个月至 15 岁的 60 名患者。
参与者随机分为两组。组 I（n=30）纳入采用长轴、无针平面内入路的患者，组 II（n=30）纳入采用短轴平面外入路的患者。
评估操作时间、针数、皮肤穿刺数、首次穿刺成功率和相关并发症。两组在人口统计学和静脉相关测量方面无差异（p>0.05）。与组 II 相比，组 I 的操作时间明显更短（32[25-38]s 比 58[42-70]s；p<0.001）。两组首次穿刺成功率无统计学差异（组 I 86.6%比组 II 80%；p=0.731）。两组的针数和皮肤穿刺数无显著差异（p=0.219 和 0.508）。两组均出现并发症，但无显著差异（4/30 比 7/30；p=0.317）。
无针、长轴平面内入路可为儿科置管提供一种安全、快速的替代方法。
