ABSTRACT

Central venous catheterization (CVC) is commonly preferred due to its benefits in the setting of pediatric intensive care units (PICUs). Ultrasound, being frequently used in the PICU setting in recent years, is also beneficial in the practice of central venous catheterization. In this research we aimed to assess the practices of ultrasound-guided CVC at our PICU.

We reviewed the findings of ultrasound-guided CVC performed on critically ill children at a 12-bed, level 3 PICU.

Between April 2014-2015, 55 patients underwent 70 procedures of CVC. Respectively 50.9% and 47.3% of the patients underwent CVC due to the absence of peripheral vessels and for the purpose of multiple drug and fluid treatment. The preference for the catheterization procedure was in favor of internal jugular vein and femoral vein at a rate of 45.7% and 54.3%, respectively. No mechanical complications occurred and the rate of success was 100% (70/70) in overall and 98.6% (69/70) for a single anatomic site. One patient showed central line-associated bloodstream infection; the rate of infection was 1.22 per 1000 catheter days and one patient had catheter-related thrombosis; of which the rate was 1.42% (1/70).

Central venous catheterization is a practice that enhances the treatment success and comfort in the setting of PICUs, particularly in critically ill patients. Our research revealed low rates of complications and manifested that ultrasound-guided CVC procedure has been safe. We think that the use of ultrasound for all appropriate invasive interventions should be more common in children.

Keywords: central venous catheterization, femoral vein, internal juguler vein, pediatric intensive care, ultrasound