Comparative study of ultrasound guided subclavian venous cannulation versus conventional technique: Advantages and disadvantages

Himanshu A Shah,Mrugank M Bhavsar

doi:10.7439/ijbar.v4i11.532

Abstract

Background: Procedures involving pediatric group is always challenging. Our aim is to compare conventional anatomical landmark technique versus the ultrasound-guided technique for Subclavian vein (SCV) cannulation in pediatric cardiac surgical patients. Material and Methods:100 patients between 2-12 years who required Subclavian vein (SCV) cannulation received catheter insertion either by conventional [n=50] or by ultrasound-guided technique [n=50] in cardiac surgeries. We observed time taken for preparation for the procedure, failed catheter placement, risk of complications, number of attempts and time to successful catheterization and infection rate, cost, incidence of venous thrombosis by ultrasound on removal of catheter in both the group

Highlights

Paediatric cardiac surgical patients need safe intravenous access for hemodynamic monitoring, drug infusion, parenteral nutrition, post operative difficult peripheral venous access, blood withdrawal for lab investigations for post operative period, blood product transfusion
It is necessary to have safe alternative which is easy to maintain for pediatric groups .Subclavian vein cannulation has certain advantages like consistent anatomical landmark and vein location with more patient comfort
Shah & Bhavsar compared with the internal jugular vein (IJV) and to the femoral vein routes 1,2 and incidence of pneumothorax is higher in Subclavian venous cannulation

Summary

Introduction

Paediatric cardiac surgical patients need safe intravenous access for hemodynamic monitoring, drug infusion, parenteral nutrition, post operative difficult peripheral venous access, blood withdrawal for lab investigations for post operative period, blood product transfusion. Our aim is to compare conventional anatomical landmark technique versus the ultrasound-guided technique for Subclavian vein (SCV) cannulation in pediatric cardiac surgical patients. Material & Methods:[100] patients between 2-12 years who required Subclavian vein (SCV) cannulation received catheter insertion either by conventional [n=50] or by ultrasound-guided technique [n=50] in cardiac surgeries. We observed time taken for preparation for the procedure, failed catheter placement, risk of complications, number of attempts and time to successful catheterization and infection rate, cost, incidence of venous thrombosis by ultrasound on removal of catheter in both the group were observed. There were a higher number of attempts, longer access time, and a more frequent complication rate in conventional group, the success rate was found to be comparable between both the two groups.

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Conclusion