A comparison of open vs ultrasound-guided percutaneous insertion of central venous catheter in children weighting five kilograms or less

Abstract

Today, ultrasound is used to find the internal jugular vein and reduce the complications of catheter insertion and increase the chance of obtaining it. The aim of this study was to evaluate the ability of ultrasound to reduce the incidence of complications during catheter placement in children weighing less than 5 kg. Methods: 111 children (weight<5 kg) who needed a central venous catheter were selected according to the inclusion and exclusion criteria and divided into two groups. In the first group (55 patients) ultrasound guided seldinger wire method and in the second group (56 patients) open method was used to insert central venous catheter. Complications such as hematoma, pneumothorax, hemothorax, hemorrhage, needle insertion into the artery, arrhythmia and death of patients during catheter insertion were recorded. Patients were evaluated for thrombosis, catheter occlusion and catheter tip migration (by echocardiography two weeks later), infection, catheter removal, and catheter dysfunction two weeks after catheter insertion. Results: The success rate of catheter implantation in the method under ultrasound guide was 85.5%. The incidence of thrombosis (3.6% vs. 5.4%), infection (1.8% vs. 7.4%) and bleeding (zero vs. 3.6%) were significantly lower in the first group (P <0.05). Hematoma (7.3% vs. 3.6%) was less common in the second group (P = 0.33). Hemothorax, pneumothorax, catheter migration and obstruction did not occur in any of the patients. In the second group, death was occurred in two patients (3.6%) due to Co-disease.