Comparison of the methods and complications of central venous catheterization via jugular vein by open approach and subclavian methods under ultrasound guidance in children weighing less than 5 kg

Abstract

Today, it is common to use ultrasound to find a suitable vein for inserting a central venous catheter, especially in children, to reduce complications and make it easier to access. In children, due to the small size of the veins and the possibility of more complications, one of the methods is to use the internal jugular vein through open surgery or under ultrasound guidance. However, in recent years, using the subclavian vein under ultrasound guidance instead of the open method on the jugular vein has attracted the attention of surgeons. Therefore, in this study, we will consider two methods of inserting the central vein catheter through the open jugular vein and the subclavian vein under ultrasound guidance. Materials & methods: In this study, 92 children under 5 kg who needed central venous catheter implantation were examined in two groups of 46 people, one group was performed through open surgery through the jugular vein and the other group was under ultrasound guidance through the subclavian vein. In this study, all children under 5 kg who First, the jugular vein method was performed under ultrasound guidance and it was not successful. They were entered into the study in two groups, and each group was evaluated in terms of complications such as pneumothorax, hemothorax, bleeding, and failure to insert the catheter, and upper limb edema within a period of two weeks after insertion. Catheters were checked. Results: In this study, there were 51 (55.4%) boys and 41 (44.6%) girls. The average age of the participants in the first group was 23.26 ± 4.5 days and in the second group was 28.06 ± 3.9 days. The average weight of patients in the first group was 2.96±0.13 kg and in the second group was 3.13±0.12 kg. The duration of catheter insertion in the first group (jugular) was 41.19±13.8 minutes and in the second group (subclavian) was 33.15±12.12 minutes, and a significant difference with P-value=0.04 was observed between the two groups. 4 cases (8.7%) of catheter insertion failure and 3 cases (6.5%) of upper limb edema in children less than 2.5 kg were in the subclavian group. In the jugular group, hematoma was significantly higher.