Retrospective analysis of 1028 ultrasound-guided central vascular access in neonates and children.

Background: The use of real-time ultrasound has become the standard of care for percutaneous central venous access and shown to decrease overall number of attempts and complication rates.

Material and method: A retrospective analysis of a prospective database was done focusing on three types of central access: non-tunneled, tunneled, and implantable, placed via ultrasound-guided Brachiocephalic Vein (BCV) between January 2019 and January 2023. Data were recorded: gender, age, weight, side (left or right), number of puncture attempts, arterial puncture, change of operator or puncture side, and mechanical complications (pneumothorax and hemothorax).

Results: A total of 1028 non-tunneled, tunneled, and implantable central lines were placed. Five hundred and eighty seven were Male. The children were aged from 0 to 18 years and their weights ranged from 1 to 113 kg. Nine hundred and thirty-five were left BCV. Right BCV was cannulated in 93 patients. Failure to cannulate left BCV was recorded in seven cases. Three arterial punctures were recorded. Cannulation success rate was 97.2% (999/1028) and was higher in left BCV than right BCV (p < 0.001).

Discussion: Based on the above, we believe that ultrasound-guided BCV is an easy and secure method to cannulate children, in our series left BCV showed a higher cannulation success rate rather than right BCV.