• Paediatric anaesthesia · Nov 2012

    Ultrasound-guided supraclavicular cannulation of the brachiocephalic vein in infants: a retrospective analysis of a case series.

    • Christian Breschan, Manuela Platzer, Robert Jost, Haro Stettner, Georg Feigl, and Rudolf Likar.
    • Department of Anaesthesia, Klinikum Klagenfurt, Klagenfurt, Austria. breschan.ch@chello.at
    • Paediatr Anaesth. 2012 Nov 1; 22 (11): 1062-7.

    BackgroundIn this study, we analyze the impact of the choice of either the left or right brachiocephalic vein (BCV) on the cannulation success when using the ultrasound-guided supraclavicular in-plane technique approach to the longitudinally viewed BCV in infants.MethodsThe central vascular protocols of 183 infants were reviewed retrospectively.ResultsThe weight ranged from 0.7 to 10 kg. Central venous catheter placement was eventually successful in 98.9%. In 141 patients (82.9%), the left BCV was successfully punctured on the first attempt, in 23 patients (13.5%) after 2 and in 6 patients (3.5%) after 3 attempts. The right BCV was successfully punctured on the first attempt in five patients (38.4%), in three patients (15.3%) after two and in five patients (38.4%) after three attempts, respectively. Significantly more puncture attempts were required for the right BCV (chi-square analysis: P < 0.01). There was also a significant improvement of the success rate over the time course of the case series (Jonckheere-test: P < 0.01).ConclusionIt seems to be easier to cannulate the left BCV than the right BCV when using this ultrasound-guided supraclavicular strict in-plane technique. Gaining experience with this method seems to improve the cannulation success.© 2012 Blackwell Publishing Ltd.

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