Right internal jugular vein, right supraclavicular and right infraclavicular subclavian vein approach to central venous cannulation in pediatric patients: A randomized comparative study
European Journal of Molecular & Clinical Medicine,
2023, Volume 10, Issue 1, Pages 2341-2355
AbstractBackground: Central venous catheterization (CVC) is an important procedure for infant patients for different purposes like nutritional support, surgical operation, hemodynamic monitoring and medications. Different approaches for CVC in children are internal jugular vein, supraclavicular subclavian and infraclavicular subclavian. The purpose of this study was to evaluate the relative effectiveness and complication risks of these three cannulation locations in infants.
Method: Assuming the effect size of 0.5 between groups, at 5% confidence level and 80% power, 10 patients were randomly assigned to each group - Group A: right internal jugular vein, Group B: right supraclavicular subclavian, Group C: right Infraclavicular subclavian. Parameters assessed were - number of attempts, successful placement of central line at superior vena casa-right atrium (SVC-RA) junction, time for insertion, complications like arterial puncture, incidence for post-op local infection, hemothorax, pneumothorax, hematoma formation. Data was compared using chi square test and ANOVA test.
Results: Time taken for catheterization in Group C was the least followed by Group A then Group B. Number of attempts taken for a successful placement of catheter in 1st attempt was maximum in Group C followed by Group A and B. It was noted that 2 of 10 patients had arterial puncture in Group A during catheterization. There was 100% successful placement in all 3 groups. No incidence of haematoma formation, haemothorax, pneumothorax, post-op local infection seen.
Conclusion: Infraclavicular approach takes the least amount of time and number of attempts for catheterization, with no incidence of any complications
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