Ultrasound-guided central venous cannulation in children

In neonates, infants and young children central venous catheters are of vital importance during surgery as well as postoperative care. The benefit of ultrasonography seems to be very important for vascular access of the internal jugular (IJV), subclavian (SCV), brachiocephalic (BCV) and femoral vein (FV). Ultrasonography enables the view of structures below the skin surface. In addition to the location of the vein and the determination of its patency prior to the puncture it makes the cannulation procedure visible to the operator under real time control. At that complications e.g. wrong guide wire migration, pneumothorax and pericardial effusion can be diagnosed quickly. Ultrasound-guided cannulations have been described in children for the IJV, infraclavicular approach to the SCV , supraclavicular approach to the SCV/BCV and FV. Studies comparing the landmark vs. ultrasound-guided technique only exist for the IJV and FV. All in all they show a clear trend in favour of the ultrasound-guided technique in terms of a higher and quicker success and lower complication rate.

This presentation is to demonstrate the current practice of the ultrasound-guided cannulation of the IJV, infraclavicular approach to the SCV , supraclavicular approach to the SCV/BCV and FV in children in terms of the sonoanatomy, cannulation technique and expert opinion including figues and videoclips.

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