Ultrasound guided percutaneous insertion is safe in Children
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The goal of this study was to compare open insertion of central access catheters performed in a tertiary paediatric hospital with ultrasonic driven percutaneous insertion in terms of safety and complication rates.

This was an ethics approved prospective randomized trial of children under 16 years of age. Procedure was performed by surgeons with varying experience with percutaneous and open insertion. Primary outcome studied was complications-immediate and late. Secondary outcomes were time taken to complete procedure, conversion rates, duration of line use.

A total of 108 patients were analyzed. 64 were male.
-Right internal jugular vein was accessed in 97.
-81 lines were double lumen, 23 implantable access devices, and the rest were single lumen catheters.
-In 22 percent of the cases, more than one needle puncture was needed, but there were no conversions in the ultrasound group.
-12 patients needed more than one insertion to achieve optimal position of the tip.
-11 patients had immediate and late complications.
-Percutaneous lines lasted 45 days longer though this was not statistically significant.
-Operating time was 20.6% shorter with percutaneous access.
-Post-removal measurement of vein size by ultrasound demonstrated significant decrease in size in the open group.

Conclusively, Ultrasound guided percutaneous insertion was safe. The study also demonstrated a decrease in operating times, preservation of vein size, and no increase in complication rates in the US group when performed by operators of varying expertise.

Source: https://www.journalofsurgicalresearch.com/article/S0022-4804(20)30824-6/fulltext
Dr. S●●●●a S●●●i
Dr. S●●●●a S●●●i General Surgery
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