P0529 / #554: IMPACT OF PERCUTANEOUS CENTRAL VENOUS CANNULATION UNDER ULTRASOUND - GUIDED IN A PEDIATRIC INTENSIVE CARE UNIT

Abstract

Aims & Objectives: Percutaneous vein cannulation in pediatric group, can be technically challenging, especially in young children. The purpose was to determine if ultrasound guided placement of percutaneous central venous catheters (CVC) would decrease the number of attempts, to achieve successful catheterization in the internal yugular vein (IYV), and femoral (FV). Methods: Design: Descriptive, prospective and analytical study between May 2018 and May 2019. Setting and participants: All patients from 1 month to 18 year- old admitted to the PICU of Garrahan Hospital, who required CVC. The insertion site was chosen by the attending physician Secondary outcome: incidence of complications Results: IYV was chosen in 66 patients (43.5%), while FV was the choice in 86 patients (56.5%). Eighty-six (56.5%) CVC, were inserted in the first attempt and 66 (43.5%), required one or more. IYV insertions were successful on the first attempt in 46 patients (53.5%) and twenty children required more than one puncture for correct catheter placement (30.3%) p 0.004 OR 0.37 (95% CI 0.18-0.78).In children under 6 months CVC placed in IYV had less risk of requiring more than one attempt, compared to those in the FV, p 0.0026 OR 0.31 (95% CI 0.12 -0.75).There were 3% complications (pneumothorax that required drainage), and there was no mortality related to the insertion method. Conclusions: Ultrasound-guided CVC insertion was safe in most cases, and significantly successful on the first attempt when the YIV was the insertion choice, especially for those under 6 months of age.