Amer J Perinatol 2018; 35(05): 503-508
DOI: 10.1055/s-0037-1608803
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Ultrasound-Guided Cannulation of the Brachiocephalic Vein in Neonates and Preterm Infants: A Prospective Observational Study

Ignacio Oulego-Erroz
Pediatric Intensive Care Unit, Complejo Asistencial Universitario de León, León, Spain
Working Group on Bedside Ultrasound of the Spanish Society of Pediatric Intensive Care (SECIP), Madrid, Spain
,
Paula Alonso-Quintela
Neonatal Intensive Care Unit, Complejo Asistencial Universitario de León, León, Spain
,
Sandra Terroba-Seara
Neonatal Intensive Care Unit, Complejo Asistencial Universitario de León, León, Spain
,
Aquilina Jiménez-González
Neonatal Intensive Care Unit, Complejo Asistencial Universitario de León, León, Spain
,
Silvia Rodríguez-Blanco
Neonatal Intensive Care Unit, Complejo Asistencial Universitario de León, León, Spain
,
José Luis Vázquez-Martínez
Working Group on Bedside Ultrasound of the Spanish Society of Pediatric Intensive Care (SECIP), Madrid, Spain
Pediatric Intensive Care Unit, Hospital Universitario Ramón y Cajal, Madrid, Spain
› Author Affiliations
Further Information

Publication History

28 August 2017

18 October 2017

Publication Date:
28 November 2017 (eFirst)

Abstract

Introduction Percutaneous central venous catheter (CVC) insertion is a challenging procedure in neonates, especially in preterm infants.

Objective This study aims to describe the technical success and safety profile of ultrasound (US)-guided brachiocephalic vein (BCV) cannulation in neonates.

Methods Prospective observational study. Neonates admitted to the neonatal intensive care unit (NICU) in whom US-guided cannulation of the BCV was attempted were eligible. Outcomes included first attempt success rate, the overall success rate, the number of attempts, the cannulation time, immediate mechanical complications, catheter indwelling days, and late complications.

Results A total of 40 procedures in 37 patients were included. Median weight and age at the time of cannulation were 1.85 kg (0.76–4.8) and 13 days (3–31), respectively. First attempt and overall success rates were 29 (72.5%) and 38 (95%), respectively. No major complications were observed. Catheter-associated infection rate was 2.4/1,000 catheter days. There were no difference in outcomes between low weight preterm infants (<1.5 kg) and the rest of the cohort. There was no linear relationship between weight at time of insertion and the number of puncture attempts (r = 0.250; p = 0.154) or cannulation time (r = 0.257; p = 0.142).

Conclusion US-guided cannulation of the BCV may be considered in acutely ill neonates, including small preterm infants, who need a large bore CVC.