Ultrasound-Guided Femoral Arterial Cannulation in Neonates Undergoing Cardiac Surgery or Catheterization: Comparison of 0.014-Inch Floppy Versus 0.019-Inch Straight Guidewire
Objectives: Percutaneous femoral artery cannulation can be technically challenging in small infants. Design: We designed a prospective randomized trial to compare the use of two different guidewires for femoral arterial cannulation in neonates undergoing cardiac surgery or catheterization. Settings: Cardiac ICU in a university hospital. Patients: One-hundred twenty-four children were enrolled in this prospective study, with 64 being randomized to the 0.019-inch straight guidewire group and 60 to the 0.014-inch floppy guidewire group. Interventions: Femoral artery cannulation. Measurements and Main Results: The study period was limited to 10 minutes at the first site of arterial puncture. The time to complete cannulation, number of successful cannulation on first attempt, number of attempts, and number of successful cannulations were compared. The number of successful cannulations and successful cannulations on first attempt were higher in 0.014-inch floppy guidewire group (p = 0.001; p = 0.002, respectively). The time to complete cannulation was significantly shorter, and the number of attempts was lower in 0.014-inch floppy guidewire group (p = 0.001). Among the neonates less than 2000g, the number of attempts and time to complete cannulation were significantly lower (p
CONCLUSION:: The ultrasound-guided oblique-axis/in-plane approach is a safe and reliable alternative to the routine ultrasound-guided approach for axillary venous catheterization. PMID: 30919718 [PubMed - as supplied by publisher]
Central venous catheter (CVC) insertion is difficult to perform and is a high-risk operation; ultrasound (US)-guided cannulation helps increase the odds of success while reducing the associated complications. The internal jugular vein (IJV) and subclavian vein (SCV) are the most commonly sites in US-guided CVC insertion. In the present study, we evaluated the safety and efficacy of US-guided supraclavicular right brachiocephalic vein (BCV) cannulations in adult patients. Between January 2016 and December 2017, 428 adult patients requiring 536 CVC insertions underwent ultrasound-guided right BCV cannulation. The success ra...
AbstractReal-time ultrasound guidance for central venous catheterization has become a standard technique. This technique has been reported to yield high success rates and fewer complications compared with landmark techniques. However, it can be risky when the practitioner does not possess proper knowledge and skills. Lose sight of the needle tip can lead to severe complications such as arterial puncture or pneumothorax. Also, posterior wall penetration of the target vessels must be avoided. Misplacement of the catheter to other vessels can sometimes occur, and may only be discovered after the catheterization procedure. To ...
CONCLUSIONS: In our experience AOP and LIP approaches have shown the same outcomes. However, we believe that the LIP technique has potential benefits and it should be considered in the decision process of IJV cannulation. PMID: 27911460 [PubMed - as supplied by publisher]
CONCLUSION: Ultrasonography (US) has improved safety and effectiveness of port system placements. While routine post-procedural CXR seems avoidable, IF should be considered mandatory. PMID: 27896794 [PubMed - as supplied by publisher]
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Conclusions: The incidence of mechanical complications is affected by the number of punctures performed. After adjustment, the risk increases substantially with more than 3 attempts. Limiting the number of attempts, appropriate supervision and the use of ultrasound guidance when available are recommended for the further reduction in mechanical complications of central venous catheterization.
ConclusionsDSFV is a novel venous access site for PICC placement with high success rate and sufficient longevity and flexibility for critically ill infants with cardiac disease. More experience and larger studies are needed to confirm its potential advantages.
CONCLUSIONS: Ultrasound-guided CVC tip confirmation following catheterization of the right subclavian vein via a right supraclavicular approach with a microconvex probe is feasible. PMID: 27012271 [PubMed - as supplied by publisher]
Abstract Central venous catheterization is an invasive procedure which can be associated with severe complications. These include in particular unsuccessful arterial puncture and vascular injuries, which in addition to loss of blood can lead to massive soft tissue swelling. A 63-year-old female patient developed massive cervical bleeding during ultrasound-guided internal jugular vein puncture and the rapidly enlarging hematoma led to compromisation of the airway. A cannot intubate, cannot ventilate situation developed and the subsequent hypoxia led to cardiac arrest that was only resolved after emergency surgical ...