Comparing open surgical, SELDINGER'S technique with surgical isolation of the vein and ultrasound guided techniques for jugular central line insertion in infants: a randomized clinical trial.

IF 1.6 3区 医学 Q2 SURGERY
Mohamed Mahmoud Salah Eldin, Sherif Mohamed K Shehata, Mohamed Ali Shehata, Ahmed Abdelmohimen Elhaddad
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引用次数: 0

Abstract

Background: Centrally Inserted Central Catheter (CICC) placing procedure is challenging in the pediatric population, especially in newborns and infants, leading to lower success and higher complication rates than in adults. The aim of this study was to compare three approaches: open technique, SELDINGER'S technique with surgical isolation of the vein, and percutaneous ultrasound-guided CICC insertion for central line insertion in infancy as regards safety, success of cannulation, technique time, and preservation of the patency of the internal jugular vein (IJV).

Methods: This prospective randomized cohort study was conducted after approval of the Ethical Committee of Tanta University Hospital with approval code: 36264MS38/1/23 (clinical trial ID: NCT06862492 and date: 03/05/2025). This study adheres to CONSORT guidelines. This study included 105 infants in need of CVC insertion over a period of 6 months. They were randomly allocated into three equal groups; group A underwent CICC insertion using the open surgical technique, group B underwent SELDINGER'S technique with surgical isolation of the vein, and group C underwent percutaneous ultrasound-guided CICC insertion.

Results: Patency was significantly higher in SELDINGER'S technique with surgical isolation of the vein and percutaneous ultrasound-guided techniques compared to the open surgical technique (P = 0.003, < 0.001). There was a significant negative correlation between patency of IJV and duration of CICC placement (r = -0.238, P = 0.010) and with the number of trials to success of the cannulation (r = -0.252, P = 0.006). The technique time was significantly shorter in the percutaneous ultrasound-guided technique compared to open surgical and SELDINGER'S technique with surgical isolation of the vein (P < 0.001, < 0.001). SELDINGER'S technique with surgical isolation of the vein was a significantly shorter technique time when compared to the open surgical technique (P < 0.001).

Conclusions: US-guided catheterization of the IJV shows more advantages in the form of a less time-consuming technique with a high first attempt and insertion success rate and fewer trials compared to CICC insertion using either open surgical technique or SELDINGER'S technique with surgical isolation of the vein.

Trial registration: Current Controlled Trials NCT06862492 and date: 03/05/2025.

比较开放手术、SELDINGER技术与手术隔离静脉和超声引导技术在婴儿颈内中心静脉插入中的应用:一项随机临床试验。
背景:在儿科人群中,特别是在新生儿和婴儿中,中央插入中心导管(CICC)放置程序具有挑战性,导致比成人更低的成功率和更高的并发症发生率。本研究的目的是比较三种方法:开放技术、SELDINGER技术与手术隔离静脉,以及经皮超声引导的ccic插入在婴儿期中心静脉插入的安全性、插管成功率、技术时间和保持颈内静脉通畅。方法:本前瞻性随机队列研究经坦塔大学医院伦理委员会批准,批准代码:36264MS38/1/23(临床试验ID: NCT06862492,日期:03/05/2025)。本研究遵循CONSORT指南。本研究纳入了105名需要植入CVC的婴儿,时间超过6个月。他们被随机分成三组;A组采用开放手术技术置入CICC, B组采用SELDINGER技术手术隔离静脉,C组采用经皮超声引导下置入CICC。结果:SELDINGER'S技术与经皮超声引导下的手术隔离静脉的通畅度明显高于开放手术技术(P = 0.003)。与使用开放手术技术或SELDINGER'S技术进行手术隔离静脉相比,us引导下的IJV置管具有更少的时间和更高的首次尝试和置入成功率以及更少的试验等优势。试验注册:Current Controlled Trials NCT06862492,日期:03/05/2025。
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来源期刊
BMC Surgery
BMC Surgery SURGERY-
CiteScore
2.90
自引率
5.30%
发文量
391
审稿时长
58 days
期刊介绍: BMC Surgery is an open access, peer-reviewed journal that considers articles on surgical research, training, and practice.
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