Placement of peripherally inserted central catheters in children guided by ultrasound: a prospective randomized, and controlled trial

Priscilla Sete de Carvalho Onofre, Mavilde da Luz Gonçalves Pedreira, Maria Angélica Sorgini Peterlini
Pediatric Critical Care Medicine 2012, 13 (5): e282-7

OBJECTIVE: To compare the use of vascular Doppler ultrasound with vein visualization and palpation for positioning peripherally inserted central catheters in children and to determine the influence of these methods on the success of the first puncture attempt, catheter positioning, and time required for the accomplishment.

DESIGN: A prospective randomized, controlled trial was conducted in a university hospital after ethical approval and was carried out among children (from birth to 18 yrs).

SETTING: São Paulo Hospital, São Paulo, Brazil.

PATIENTS: The sample comprises 42 peripherally inserted central catheters insertions allocated randomly into two groups: 1) an ultrasound group with 21 peripherally inserted central catheters guided by ultrasound; and 2) a control group with 21 catheters, in which the peripherally inserted central catheters were inserted using vein visualization and palpation.

INTERVENTIONS: The procedure was performed by two trained nurses using a standard protocol for peripherally inserted central catheter insertion and ultrasound use. Ultrasound group equipment was ILook25 (Sonosite, Bothell, WA) with a 25-mm, 10- to 15-MHz linear array transducer that reaches a 4-cm depth.

MEASUREMENTS AND MAIN RESULTS: Success in the first puncture attempt was higher (p = .003) in the ultrasound group (90.5%) than in the control group (47.6%). The catheter positioning success rate was 85.7% in the ultrasound group and 52.4% in the control group (p = .019). The median time spent on the procedure for the ultrasound group was 20 mins, whereas it was 50 mins for the control group (p = .001).

CONCLUSION: The use of ultrasound increased the successful positioning of peripherally inserted central catheters in comparison with the venous anatomic landmark visualization and palpation technique and further optimized the time spent on the procedure.

Full Text Links

Find Full Text Links for this Article


You are not logged in. Sign Up or Log In to join the discussion.

Related Papers

Remove bar
Read by QxMD icon Read

Save your favorite articles in one place with a free QxMD account.


Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"