Ultrasound-Guided Supraclavicular Approach to the Brachiocephalic Vein Cannulation in Pediatric Patients With Hematological and Oncological Diseases

Abstract

Purpose: Central venous catheters (CVCs) are used in the treatment of pediatric hematological and oncological diseases. Recently, the ultrasound (US)-guided supraclavicular approach to brachiocephalic vein cannulation with in-plane views has been described as a safe central venous catheterization technique.

Methods: A retrospective study was performed on patients who underwent US-guided tunneled CVC insertion into the internal jugular vein with out-of-plane views (IJV group) and the brachiocephalic vein with in-plane views (BCV group). The patients’ background characteristics, surgical outcomes, and complications were compared retrospectively.

Results: A total of 40 tunneled CVCs (IJV group: n = 15, BCV group: n = 25) were inserted in 34 patients. The patients’ background characteristics were not significantly different between the two groups. The operative times were 30 min (range: 27–33 min) in the IJV group and 25.8 min (range: 22–27 min) in the BCV group. The BCV group had a significantly shorter operative time (p = 0.0026). Intraoperative complications were observed in one patient (6.7%) in the IJV group and none of the patients in the BCV group. Complications during maintenance were observed in 10 patients (66.7%) in the IJV group and 17 patients (68%) in the BCV group. Catheter-related bloodstream infection was noted in 10 patients (66.7%) in the IJV group and 12 patients (52%) in the BCV group; these infection rates were not significantly different. The periods of CVC implantation were 273 days (172–363.5 days) in the IJV group and 152 days (101–280 days) in the BCV group, which were not significantly different.

Conclusions: A real-time US-guided supraclavicular approach to brachiocephalic catheterization was considered a safe technique for pediatric patients with hematological and oncological diseases.