Combined short-axis out-of-plane and long-axis in-plane approach versus long-axis in-plane approach for ultrasound-guided central venous catheterization in infants and small children: A randomized controlled trial

The ultrasound-guided long-axis in-plane approach for central venous catheterization in infants and small children can prevent posterior wall penetration. The combined short-axis out-of-plane and long-axis in-plane approach reportedly prevents such penetration in adults. To test the hypothesis of no...

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Bibliographic Details
Published in:PloS one 2022-09, Vol.17 (9), p.e0275453-e0275453
Main Authors: Takeshita, Jun, Nakajima, Yasufumi, Tachibana, Kazuya, Hamaba, Hirofumi, Yamashita, Tomonori, Shime, Nobuaki
Format: Article
Language:English
Subjects:
Biology and Life Sciences
Catheterization
Catheters
Children
Clinical trials
Complications and side effects
Diseases
General anesthesia
Infants
Intubation
Jugular vein
Medical personnel
Medicine and Health Sciences
Patient outcomes
Patients
Pediatrics
Penetration
People and Places
Research and Analysis Methods
Review boards
Scanning
Success
Ultrasonic imaging
Ultrasound
Veins & arteries
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Summary:The ultrasound-guided long-axis in-plane approach for central venous catheterization in infants and small children can prevent posterior wall penetration. The combined short-axis out-of-plane and long-axis in-plane approach reportedly prevents such penetration in adults. To test the hypothesis of non-inferiority of the combined approach to the long-axis in-plane approach, we compared the two approaches in infants and small children. Patients were randomized based on whether they underwent ultrasound-guided internal jugular vein catheterization using the combined or long-axis in-plane approach. Posterior wall penetration rates, first-attempt success rates, overall success rates within 20 min; scanning, puncture, and procedure durations; and number of attempts were compared between the groups. In the combined and long-axis in-plane groups ( n = 55 per group), the posterior wall penetration rates were 5.5% (3/55) and 3.6% (2/55) ( P = 0.65), the first-attempt success rates were 94.5% (52/55) and 92.7% (51/55) ( P = 0.70), and the overall success rates within 20 min were 100% (55/55) and 98.2% (54/55) ( P = 0.32), respectively. In the combined and long-axis in-plane groups, the median (interquartile range) scanning durations were 21 (16.5–34.8) s and 47 (29.3–65) s ( P
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0275453