scholarly journals Ultrasound-Guided Central Venous Access With Different Anesthesia Methods in Neonatal Intensive Care Unit

Cureus ◽  
2021 ◽  
Author(s):  
Mustafa Okumuş ◽  
Adil Umut Zubarioglu
2020 ◽  
pp. 112972982096929
Author(s):  
Matthew Ostroff ◽  
Adel Zauk ◽  
Sara Chowdhury ◽  
Nancy Moureau ◽  
Carly Mobley

Objective: The purpose of this retrospective analysis was to evaluate the clinical efficacy and safety of ultrasound (US)-guided, subcutaneously tunneled, femoral inserted central catheters (ST-FICCs) in the neonatal intensive care unit (NICU). Methods: Following clinical success with ST-FICCs in adults, we expanded this practice to the neonatal population. In an 18-month retrospective cohort analysis (2018–2020) of 82 neonates, we evaluated the clinical outcome for procedural success, completion of therapy, and incidence of early and late complications for insertion of US-guided ST-FICCs in the NICU. Results: Placement of ST-FICCs were successful in 100% of neonates ( n = 82/82) with 94% to the right ( n = 77/82) and 6% to the left common femoral veins ( n = 5/82). Gestational age ranged 23-39 weeks with median age of 29 weeks. Birthweight ranged from 450 g to >2000 g. Weight at insertion ranged 570 to 3345 g and day of life 1 to 137, with median at day 5. Ultrasound guided femoral vein puncture was recorded on 74 patients, first attempt 63/74 (85%), second attempt 8/74 (11%) and third attempt 3/74 (4%). Catheter french used: 1.9Fr ( n = 80/82), 2.6Fr ( n = 1/82), and 3-Fr ( n = 1/82). Catheter lengths were 8 to 20 cm, average 12cm. Catheter termination confirmed with posterior/anterior and lateral abdominal radiographs with inferior vena cava (IVC) ( n = 33/82), IVC/right atrial junction ( n = 31/82), or right atrium ( n = 18/82). Atrial placements were retracted; no cases of malposition to the lumbar/renal/hepatic veins ( n = 0/82). 1528 catheter days ranging 5 to 72 days (average 18). No insertion-related or post-insertion complications. All patients completed prescribed therapy with one catheter. Conclusion: Bedside placement of an ST-FICC is a safe route for central venous access in the NICU, preserving upper extremity vasculature, eliminates risks associated with sedation, fluoroscopy, tunneled and non-tunneled supra-diaphragmatic central venous insertion.


Perinatology ◽  
2019 ◽  
Vol 30 (2) ◽  
pp. 60 ◽  
Author(s):  
Young Duck Kim ◽  
Na Mi Lee ◽  
Su Yeong Kim ◽  
Dae Yong Yi ◽  
Sin Weon Yun ◽  
...  

2020 ◽  
pp. 112972982094017
Author(s):  
Giovanni Barone ◽  
Mauro Pittiruti ◽  
Gina Ancora ◽  
Giovanni Vento ◽  
Francesca Tota ◽  
...  

Objective: Central venous access in critically ill newborns can be challenging. Ultrasound-guided brachio-cephalic vein catheterization is a relatively new procedure, recently introduced in several neonatal intensive care units. The aim of this study is to evaluate the safety and feasibility of such a technique in preterm babies. Design: Retrospective analysis of prospectively collected data on ultrasound-guided central venous catheter insertion in preterm neonates. Setting: Neonatal intensive care unit. Patients: Critically ill preterm neonates with weight below 1500 g requiring a central access. Interventions: Ultrasound-guided brachio-cephalic vein catheterization. Main Results: Thirty centrally inserted catheters were placed in 30 neonates. The success rate of the procedure was 100%. No case of accidental arterial or pleural puncture was registered during the study period. Conclusion: The brachio-cephalic vein can be safely catheterized in preterm newborns requiring intensive care after appropriate training.


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