Newly Published
Perioperative Medicine  |   September 2017
A Retrospective Analysis of the Clinical Effectiveness of Supraclavicular, Ultrasound-guided Brachiocephalic Vein Cannulations in Preterm Infants
Author Notes
  • From the Department of Anesthesia, Klinikum Klagenfurt, Klagenfurt, Austria (C.B., G.G., S.N., M.K., R.L.); Department of Anesthesia, Krankenhaus Spittal/Drau, Spittal/Drau, Austria (R.J.); Department of Statistics, University of Klagenfurt, Klagenfurt, Austria (H.S.); Department of Anatomy, Medical University of Graz, Graz, Austria (G.F.); Department of Neurorehabilitation, Krankenhaus Hermagor, Hermagor, Austria (C.S.).
  • Submitted for publication March 13, 2017. Accepted for publication August 23, 2017.
    Submitted for publication March 13, 2017. Accepted for publication August 23, 2017.×
  • Research Support: Support was provided solely from institutional and/or departmental sources.
    Research Support: Support was provided solely from institutional and/or departmental sources.×
  • Competing Interests: The authors declare no competing interests.
    Competing Interests: The authors declare no competing interests.×
  • Correspondence: Address correspondence to Dr. Breschan: Department of Anesthesia, Klinikum Klagenfurt, Feschnigstrasse 11, 9020 Klagenfurt, Austria. breschan.ch@chello.at. Information on purchasing reprints may be found at www.anesthesiology.org or on the masthead page at the beginning of this issue. Anesthesiology’s articles are made freely accessible to all readers, for personal use only, 6 months from the cover date of the issue.
Article Information
Perioperative Medicine / Pediatric Anesthesia / Radiological and Other Imaging
Perioperative Medicine   |   September 2017
A Retrospective Analysis of the Clinical Effectiveness of Supraclavicular, Ultrasound-guided Brachiocephalic Vein Cannulations in Preterm Infants
Anesthesiology Newly Published on September 14, 2017. doi:10.1097/ALN.0000000000001871
Anesthesiology Newly Published on September 14, 2017. doi:10.1097/ALN.0000000000001871
Abstract

Background: The aim of this retrospective analysis was to evaluate the clinical effectiveness of the supraclavicular ultrasound-guided cannulation of the brachiocephalic vein in preterm infants.

Methods: The ultrasound probe was placed in the supraclavicular region so as to obtain the optimum sonographic long-axis view of the brachiocephalic vein. By using a strict in-plane approach the brachiocephalic vein was cannulated by advancing a 22- or 24-gauge iv cannula from lateral to medial under the long axis of the ultrasound probe under real-time ultrasound guidance into the vein.

Results: One hundred and forty-two cannulations in infants weighing between 0.59 and 2.5 kg (median: 2.1; CI: 2.0 to 2.2) were included. Ultimate success rate was 94% (134 of 142). One cannulation attempt was required in 100 (70%) patients, two attempts in 21 (15%), and three attempts in 13 (9%). The smaller the weight of the infant the more attempts were needed. More attempts also were needed for the right brachiocephalic vein, which was primarily targeted in 75 (53%) neonates. One (1%) inadvertent arterial puncture was noted.

Conclusions: This supraclavicular, in-plane, real-time, ultrasound-guided cannulation of the brachiocephalic vein seems to be a convenient and effective method to insert central venous catheters in preterm infants.