Pediatric Intensive Care Units
Conditions
Interventions
Intervention in the Study Group (US guidance Group):
Thirty-nine patients were randomized to the intervention group and underwent venipuncture of the internal jugular vein under direct visualization i
Device
Procedure/surgery
Sponsors
Hospital das Clínicas da Universidade Estadual de Campinas
Hospital das Clínicas da Universidade Estadual de Campinas
Eligibility
Age
28 Days to 14 Years
Inclusion criteria
Inclusion criteria: Patients aged 28 days to 14 years who required central venous access (at the discretion of the attending physician); Patients admitted at PICU in the presence of at least one of the researchers
Exclusion criteria
Exclusion criteria: Children with internal jugular vein thrombosis; Children with coagulation disorders; Children with tracheostomy; Children who underwent cannulation of veins other than internal jugular veins
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| EXPECTED OUTCOME 1 The expected primary outcome was a 25% reduction in failure rates for central venous catheterization. Categorical variables were described as absolute and relative frequencies. After the intervention, the Pearson's chi-squared or Fisher's exact test were used to compare proportions. All analyses were performed in SPSS version 22.0. Significance was defined as p < 0.05;OUTCOME FOUND 1 Successful venous puncture was achieved in 94.9% (37/39) and 61% (25/41) of patients in the US-guidance and control groups, respectively (relative risk [RR] = 0.64, 95% confidence interval [CI] 0.50–0.83; p <0.001). | — |
Secondary
| Measure | Time frame |
|---|---|
| EXPECTED OUTCOME 2 Increase venipuncture rates successfully in up to three tests. Categorical variables were described as absolute and relative frequencies. After the intervention, the Pearson's chi-squared or Fisher's exact test to compare proportions. All analyses were performed in SPSS version 22.0. Significance was defined as p < 0.05;OUTCOME FOUND 2 Success during the first attempt was seen in 94.9% (37/39) and 34.1% (14/41) of venous punctures in the US guidance and control groups, respectively (p <0.001). ;EXPECTED OUTCOME 3 Reduction in puncture times. After the intervention, the Mann–Whitney U test was used to compare medians between groups.;OUTCOME FOUND 3 The median puncture time was significantly lower in the US guidance than in the control group (16 sec, IQR [8-39] vs. 81 sec, IQR [16-346], respectively; p = 0.003, Fig 2). ;EXPECTED OUTCOME 4 Reduction in number of attempts required to success. After the intervention, the Mann–Whitney U test was used to compare medians between groups.;OUTCOME FOUND 4 The median number of required attempts for successful cannulations was lower in the US guidance group than in the control group (1 attempt, IQR [1-1] vs. 1 attempt, IQR [1-3]; p = 0.001).;EXPECTED OUTCOME 5 Reduction in the rate of complications such as hematomas, arterial puncture, pneumothorax and procedural-related infections. Categorical variables were described as absolute and relative frequencies. After the intervention, the Pearson's chi-squared or Fisher's exact test to compare proportions. All analyses were performed in SPSS version 22.0. Significance was defined as p < 0.05;OUTCOME FOUND 5 Neither pneumothorax nor infections procedure-related were reported in either group. The incidences of hematomas, the most frequent complication, were 2.6% (1/39) and 26.8% (11/41) in the US guidance and control groups, respectively (RR = 0.73, 95% CI 0.61–0.89; p = 0.003; Table 1). The second most frequent complication was arterial puncture, which o | — |
Countries
Brazil
Contacts
Public ContactTiago Souza
Universidade Estadual de Campinas
Outcome results
None listed