Catheter Complications, Critical Illness
Conditions
Keywords
ultrasound, catheter, long axis, short axis, pediatrics, syringe free
Brief summary
Internal jugular, subclavian, or femoral veins are often used for central venous catheter (CVC) placement. Regardless of which vein is preferred, the Seldinger technique is used most frequently. The most commonly used method with ultrasound is the short-axis out-of-plane approach. The main problem in this method is that the correct needle tip is missed, and it causes some complications by causing posterior wall punctures. The Syringe-free technique is first reported by Matias et al. in adults; it is a technique that allows full real-time monitoring of the guidewire insertion into the vein without blood aspiration. It is a great advantage in CVC placement, especially with the long-axis in-plane approach. When the literature is reviewed, no study other than a 12 case study in which brachiocephalic vein catheterization related to CVC placement was performed using this technique in children was found. There is no randomized study comparing the Syringe-free Long-Axis In-Plane technique with the classic Short-Axis Out-of-Plane technique in pediatric patients. This study compares these two techniques' efficacy and complication rates in critically ill children requiring CVC placement.
Interventions
DEVICELong-axis syringe free in-plane
Long-axis syringe-free in-plane catheter placement
DEVICEShort-axis out-of-plane
Short-axis out-of-plane catheter placement
Sponsors
Ataturk University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
3 Months to 15 Years
Healthy volunteers
No
Inclusion criteria
* Patients older than 3 months, younger than 15 years old * Critical illness pediatrics
Exclusion criteria
* Patients younger than 3 months and older than 15 years, * body weight less than 5000 gr, * anatomical malformation in the neck, * infection at the intervention site, * thrombosis
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Performing time | First 10 minutes | The time between the insertion of the needle through the skin and insertion of the guidewire into the internal jugular vein. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Complications | First 24 hours | Catheter related complications |
| Number of neddle pass | First 10 minutes | a change in needle direction without pulling the entire needle out of the skin |
| First pass success | First 10 minutes | Successful catheterization with only one needle pass. |
| New puncture | First 10 minutes | Withdraw the needle from the skin to change the puncture site |
Countries
Turkey (Türkiye)
Outcome results
None listed