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.
Keywords
ultrasound - central venous catheter - neonate - preterm - brachiocephalic vein -
neonatal intensive care unit
