Ultrasound-Guided Supraclavicular Approach to the Brachiocephalic Vein Cannulation in Pediatric Patients With Hematological and Oncological Diseases

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  • Nakame Kazuhiko
    Division of the Gastrointestinal, Endocrine and Pediatric Surgery, Department of Surgery, Faculty of Medicine, University of Miyazaki Center for Perinatal Medicine, University of Miyazaki
  • Masuya Ryuta
    Division of the Gastrointestinal, Endocrine and Pediatric Surgery, Department of Surgery, Faculty of Medicine, University of Miyazaki
  • Nakazawa Shun
    Division of Pediatrics, Faculty of Medicine, University of Miyazaki
  • Nakagawa Midori
    Division of Pediatrics, Faculty of Medicine, University of Miyazaki
  • Yamada Ai
    Division of Pediatrics, Faculty of Medicine, University of Miyazaki
  • Kinoshita Mariko
    Division of Pediatrics, Faculty of Medicine, University of Miyazaki
  • Kamimura Sachiyo
    Division of Pediatrics, Faculty of Medicine, University of Miyazaki
  • Moritake Hiroshi
    Division of Pediatrics, Faculty of Medicine, University of Miyazaki
  • Ieiri Satoshi
    Department of Pediatric Surgery, Research Field in Medical and Health Sciences, Medical and Dental Area, Research and Education Assembly, Kagoshima University
  • Nanashima Atushi
    Department of Surgery, Faculty of Medicine, University of Miyazaki

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Other Title
  • 小児血液・悪性固形腫瘍患者に対する鎖骨上アプローチを用いた腕頭静脈穿刺による中心静脈カテーテル挿入術の検討
  • ショウニ ケツエキ ・ アクセイ コケイ シュヨウ カンジャ ニ タイスル サコツ ジョウ アプローチ オ モチイタ ワントウ ジョウミャク センシ ニ ヨル チュウシン ジョウミャク カテーテル ソウニュウジュツ ノ ケントウ

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Abstract

<p>Purpose: Central venous catheters (CVCs) are used in the treatment of pediatric hematological and oncological diseases. Recently, the ultrasound (US)-guided supraclavicular approach to brachiocephalic vein cannulation with in-plane views has been described as a safe central venous catheterization technique.</p><p>Methods: A retrospective study was performed on patients who underwent US-guided tunneled CVC insertion into the internal jugular vein with out-of-plane views (IJV group) and the brachiocephalic vein with in-plane views (BCV group). The patients’ background characteristics, surgical outcomes, and complications were compared retrospectively.</p><p>Results: A total of 40 tunneled CVCs (IJV group: n = 15, BCV group: n = 25) were inserted in 34 patients. The patients’ background characteristics were not significantly different between the two groups. The operative times were 30 min (range: 27–33 min) in the IJV group and 25.8 min (range: 22–27 min) in the BCV group. The BCV group had a significantly shorter operative time (p = 0.0026). Intraoperative complications were observed in one patient (6.7%) in the IJV group and none of the patients in the BCV group. Complications during maintenance were observed in 10 patients (66.7%) in the IJV group and 17 patients (68%) in the BCV group. Catheter-related bloodstream infection was noted in 10 patients (66.7%) in the IJV group and 12 patients (52%) in the BCV group; these infection rates were not significantly different. The periods of CVC implantation were 273 days (172–363.5 days) in the IJV group and 152 days (101–280 days) in the BCV group, which were not significantly different.</p><p>Conclusions: A real-time US-guided supraclavicular approach to brachiocephalic catheterization was considered a safe technique for pediatric patients with hematological and oncological diseases.</p>

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