JOURNAL ARTICLE
RANDOMIZED CONTROLLED TRIAL

How useful is ultrasound guidance for internal jugular venous access in children?

Gabriela Ruschel Zanolla, Matteo Baldisserotto, Jefferson Piva
Journal of Pediatric Surgery 2018, 53 (4): 789-793
28843837

PURPOSE: The aim of this study was to determine whether US reduces number of puncture attempts, procedure time, and complication rate during IJV access in children.

METHODS: A prospective study was performed in children (age ≤18years) admitted to our institution, from September 2013 to July 2014, with indications for central venous access. Patients meeting the inclusion criteria were randomized to the US-guided or control groups. The same physician performed all IJV cannulations in both groups. The end-points for comparison were: length of time to venous access, number of attempts, and rate of complications.

RESULTS: Fifty-one patients were included: 23 in the US-guided group and 28 in the control group. There were no between-group differences in weight, age, or sex. In the US-guided group, the number of punctures needed to achieve IJV access (median [interquartile range], 3 [2-5] vs. 1 [1, 2]; P<0.001), time to achievement of venous access, and complication rate (39% vs. 4.3%, P<0.009) were significantly lower.

CONCLUSION: US guidance is a useful adjunct to central venous access in children, facilitating the procedure, decreasing time to cannulation, and increasing safety.

TYPE OF STUDY: Prospective randomized study.

LEVEL OF EVIDENCE: 1.

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