Ultrasonography for pediatric central vein catheterisation in inexperienced hands: A preliminary report

Objective: Central venous catheterization is a technically difficult procedure in pediatric patients. Ultrasound guidance is becoming popular during the procedure. This study is designed to examine the success rate of ultrasound guidance during internal jugular vein catheterization and factors influencing the success rate in pediatric patients. Methods: Pediatric patients who underwent central venous catheterization within a period of 12 months were included in the study. After routine anesthesia induction and treatment, patients were positioned for catheterization. Ultrasound-guided catheterization was performed. The performer specified the time to switch cutdown method for catheterization. The patients’ demographic characteristics, the performers’ experience, cannulation side, number of attempts and complications were recorded. Success was defined as accomplishment of ultrasound-guided catheterization. Results: In 144 out of 180 patients, cannulation was achieved at the first attempt. Only in 8 catheterization procedures, more than one performer tried to realize the intervention. Nine patients had cutdowns for cannulation, which meant that ultrasound guidance was successful in cannulation of 171 (95%) patients. Seven cutdowns were performed by the attending physicians, and the other two by residents. Complications as arterial puncture, hemothorax, and pneumothorax were not seen during catheterization. Conclusion: Ultrasonografi is a very useful tool for catheterization in pediatric patients even in inexperienced hands. Experience is an important factor for improving the success.