A Study on Central Vein Cannulation Using Audible Doppler Guidance in Children and Infants

Ahn, Young Joon; Jung, Jin Young; Hong, Soo Jong

Abstract

PURPOSE: Percutaneous cannulation of the central vein in children and infants may be technically difficult and can cause serious complications. There are many techniques to improve the success rate and to decrease the complications in central vein cannulation. This study was undertaken to determine whether audible Doppler guidance can help operators improve the results of central vein cannultion in pediatric ICU.
METHODS
A total of 46 central vein cannulations were performed using audible Doppler guidance technique. Using an 8-MHz Doppler ultrasound device(Pocket-Dop II. iMex. USA), the artery and the vein were identified by their characteristic Doppler sounds.
RESULTS
There was a total of 46 patients with 20 boys and 26 girls, respectively. The mean age was 3 years+/-45 months(range : 1-156 months). The number of infants was 18 and the mean age was 6.3+/-3.8 months(range : 1-12 months). The most common site of central vein cannulation was the right internal jugular vein(63%). The cannulation was successful in 44 out of 46 procedures (96%). The success rate at the first attempt was 59% with 48% in the patients who had the history of previous cannulation and 70% in the patients who did not, respectively. The success rate in infants was 94%(17 out of 18). The average access time was 5.2+/-8.3 minutes in children contrary to 7.5+/-10.3 minutes in infants. There were no serious complications, but six patients had complications including four hematoma, one arterial puncture, and one pneumothorax.
CONCLUSION
This central vein cannulation using Doppler guidance may improve the success rate of central vein cannulation and decrease the development of serious complications in infants and children.