Comparison between ultrasound-guided supraclavicular and infraclavicular approaches for subclavian venous catheterization in childrenua randomized trial
Comparison between ultrasound-guided supraclavicular and infraclavicular approaches for subclavian venous catheterization in childrenua randomized trial
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DOI：
10.1093/bja/aet202
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发表时间：
2013-11-01
影响因子：
9.8
通讯作者：
Kim, J. -T.
中科院分区：
文献类型：
--
作者：
Byon, H. -J.;Lee, G. -W.;Kim, J. -T.
超声（US）引导下锁骨下静脉（SCV）导管插入术经锁骨上（SC）或锁骨下（IC）入路可用于儿童。本研究的目的是比较这些方法的有效性。这项前瞻性的随机研究包括98名3岁的儿童，并将其分为两组：SC组（n 49）和IC组（n 49）。所有SCV导管插入术均由US引导，并由一名经验丰富的麻醉师进行。对穿刺时间、尝试次数、成功导丝插入、导管插入时间和并发症等数据进行分析，IC组的中位穿刺时间长于SC组（48 vs 36 s，P 0. 02）。IC组需要多次尝试（尝试次数> 3）的频率高于SC组（24.5 vs 6.1，P0.01）。IC组的导丝错位发生率高于SC组[10（20.4）vs 0（0），P0.001]。所有患者均成功进行了导管插入术。两组均未发生气胸或动脉穿刺。在儿科患者的超声引导下SCV导管插入术中，与IC approach.ClinicalTrials.gov，NCT 01527175相比，SC入路的穿刺时间更短，导丝错位的发生率更低。
Ultrasound (US)-guided subclavian vein (SCV) catheterization via the supraclavicular (SC) or infraclavicular (IC) approaches can be useful in children. The purpose of this study was to compare the efficacy of these approaches.This prospective, randomized study included 98 children who were 3 years old, and who were divided into two groups: the SC group (n49) and the IC group (n49). All SCV catheterizations were guided by US and performed by a single experienced anaesthesiologist. Data regarding puncture time, number of attempts, successful guidewire insertion, catheter insertion time, and complications were analysed.The median puncture time was longer in the IC group than the SC group (48 vs 36 s, P0.02). Multiple attempts (number of attempts 3) were more frequently required in the IC group than the SC group (24.5 vs 6.1, P0.01). The incidence of guidewire misplacement was higher in the IC group than that of the SC group [10 (20.4) vs 0 (0), P0.001]. Catheterization was successfully performed in all patients. No pneumothoraces or arterial punctures occurred in either group.During SCV catheterization under US guidance in paediatric patients, the SC approach yielded a shorter puncture time and decreased the incidence of guidewire misplacement when compared with the IC approach.ClinicalTrials.gov, NCT01527175.