Canalización del tronco braquiocefálico guiada por ecografía en neonatos y lactantes

  1. Ignacio Oulego-Erroz 13
  2. Paula Alonso-Quintela 13
  3. Patricia Domínguez 1
  4. Silvia Rodríguez-Blanco 1
  5. Manoel Muñíz-Fontán 1
  6. Ana Muñoz-Lozón 1
  7. Gloria López-Blanco 1
  8. Antonio Rodríguez-Nuñez 2
  1. 1 Servicio de Pediatría, Complejo Asistencial Universitario de León
  2. 2 Servicio de Críticos y Urgencias Pediátricas, Complejo Hospitalario Universitario de Santiago de Compostela
  3. 3 IBIOMED, Instituto de Biomedicina de León
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Journal:
Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría ( AEP )

ISSN: 1695-4033,  1696-4608

Year of publication: 2016

Volume: 84

Issue: 6

Pages: 331-336

Type: Article

DOI: 10.1016/J.ANPEDI.2015.03.013 PMID: 25979387 SCOPUS: 2-s2.0-84929093651 DIALNET GOOGLE SCHOLAR lock_openOpen access editor

More publications in: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría ( AEP )

Abstract

Introduction Central venous catheter (CVC) insertion in neonates and small infants is a challenging and high risk procedure. Ultrasound (US) guided cannulation increases the success rate and reduces procedural-related complications. The internal jugular vein is the most frequent site for US-guided CVC insertion. However this approach is technically demanding in neonates and small infants. US-guided supraclavicular cannulation of the brachiocephalic vein (BCV) is a new approach that may be advantageous in case of difficult central venous catheterization. We present our preliminary experience with this technique in a case series of neonates and small infants. Methods Case series of neonates and small infants weighing less than 5kg, in whom US-guided supraclavicular cannulation of the BCV was attempted. A longitudinal “in plane” supraclavicular approach to the BCV was performed using a 12Hz linear or a 8Hz microconvex transducer. All cannulations were performed by the same operator, a pediatrician with previous experience in US-guided central venous catheterization. Results The study included 6 patients with a median (range) weight of 2.1 (0.94-4.1) kg and age of 1.9 (0.6-4) months. Two cases required 2 punctures, while cannulation was achieved at the first attempt in the remaining 4 cases. There were no procedural or catheter-related complications. CVCs were withdrawn after 9 (6-15) days. Conclusions The US-guided supraclavicular approach to the BCV is a feasible and safe alternative in neonates and very small infants. More studies are needed to define the role of this new venous access before its routine application in daily practice.

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