Abstract
Background:
Real-time ultrasound (US) guidance for central venous catheter (CVC) insertion has been shown to increase cannulation success rates and reduce complications in adults. Literature regarding US-guided CVC placement in children remains limited and conflicting. This meta-analysis examines the efficacy and safety of US-guided CVC placement among pediatric patients.
Methods:
A comprehensive literature search of all published randomized control trials (RCTs) comparing the use of real-time US-guided CVC insertion with anatomic landmark (LM)-guided CVC insertion in pediatric patients <18 y of age was conducted. Outcomes analyzed were cannulation success rate, number of attempts required, incidence of accidental arterial puncture, and time to cannulation.
Results:
Eight RCTs involving 760 patients were analyzed. US-guided CVC insertion significantly increased success rates by 31.8% and decreased the mean number of attempts required. A trend toward a decrease in the risk of accidental arterial puncture with the use of US-guided CVC insertion was also observed. US-guided CVC insertion was not associated with a significant difference in time required for CVC placement.
Conclusion:
US-guided CVC placement is associated with significantly higher success rates and decreased mean number of attempts required for cannulation. US-guided CVC insertion improves success rates, and should be utilized in pediatric patients.
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Lau, C., Chamberlain, R. Ultrasound-guided central venous catheter placement increases success rates in pediatric patients: a meta-analysis. Pediatr Res 80, 178–184 (2016). https://doi.org/10.1038/pr.2016.74
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DOI: https://doi.org/10.1038/pr.2016.74
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