ULTRASOUND-GUIDED CENTRAL LINE INSERTION IN CHILDREN: HOW MUCH IMAGING IS REALLY NEEDED?

Authors

  • Sofia Vasconcelos-Castro Department of Pediatric Surgery, Centro Hospitalar Universitário São João, Porto, Portugal https://orcid.org/0000-0002-1000-7324
  • Beatriz Flor-de-Lima Department of Radiology. Centro Hospitalar Universitário São João, Portugal
  • Miguel Soares-Oliveira Department of Pediatric Surgery, Centro Hospitalar Universitário São João, Porto, Portugal

DOI:

https://doi.org/10.48729/pjctvs.222

Keywords:

pediatrics, central line, ultrasound, chest radiography

Abstract

Introduction: A recent survey revealed that most pediatric surgeons use intraoperative fluoroscopy and routine postoperative chest radiography for catheter tip location in central line placement. The aim of this study is to review all cases of ultrasound-guided central line placements and to evaluate the role of postoperative chest radiography.

Methods: Retrospective data analysis of children submitted to percutaneous central line insertion under ultrasound control over a 2-year period in a pediatric surgery department. Data collected included: age, indication for central venous access, catheter type, usage of intraoperative fluoroscopy and postoperative chest radiography, complications, and whether chest radiography dictated any catheter-related intervention.

Results: Fifty-five long-term central lines were successfully established in children aged between 1 month and 17 years. All patients had the catheter tip position confirmed either by intraoperative fluoroscopy (96%), chest radiography (85%) or both (82%). Catheter tip overlying the cardiac silhouette (right atrium) on chest radiography was reported in 4 cases; these findings led to no change in catheter positioning or other catheter-related intervention. There were no catheter-related complications.

Conclusions: Percutaneous central line insertion under US-control is safe and effective even in small children. Post- operative chest radiography did not dictate any modification of catheter tip positioning after central line placement with ultrasound and fluoroscopic control or identified any other complication, thus should not be used routinely.

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Published

04-01-2022

How to Cite

1.
Vasconcelos-Castro S, Flor-de-Lima B, Soares-Oliveira M. ULTRASOUND-GUIDED CENTRAL LINE INSERTION IN CHILDREN: HOW MUCH IMAGING IS REALLY NEEDED?. Rev Port Cir Cardiotorac Vasc [Internet]. 2022 Jan. 4 [cited 2022 Jan. 28];28(4):37-41. Available from: https://pjctvs.com/index.php/journal/article/view/222

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Original Articles