Abstract :
In pediatric intensive care, central venous cannulation is prevalent and necessary. This technique does not, however, come without dangers or difficulties. Even though central venous cannulation has traditionally been performed by anatomical landmarks, ultrasound guidance has essentially superseded the latter because of its superior efficacy and safety profile, at least in adult populations. To compare the ultrasound-guided and anatomical landmark techniques in inserting femoral central venous catheters in critical care pediatric patients. Patients planned to insert a central venous catheter in the pediatric intensive care unit; eighty patients were randomized: 40 were assigned to the ultrasound-guided group and 40 to the anatomical landmark group. In the anatomical landmark group, the traditional method consisted of palpating the femoral artery pulse as a landmark; in the ultrasound-guided group, the Central venous cannulation was inserted using ultrasound guidance. Success at the first at-tempt, overall success in cannulation, number of attempts, and arterial puncture were the variables studied in both groups. Success at the first attempt was significantly higher in the ultrasound-guided group versus the anatomical landmark (57.5% versus 10%, p-value 0.001). Overall successful canulation was also higher in the ultrasound-guided group (97.5%, p-value 0.556), and the incidence of the femoral artery puncture was lower in the ultrasound-guided group (10%, p-value 0.13) without achieving statistical significance. According to this study, cannulation success of the central venous catheter in the femoral vein is highly increased by using ultrasound-guided technique, especially at the first attempt, and this minimizes the rate of arterial puncture complication, so it is superior to landmark technique.
