Open Versus Ultrasound Guided Tunneled Central Venous Access in children: A Randomized Controlled Study.

Soundappan, SSV; Lam, L; Cass, DT; Karpelowsky, J

Open Versus Ultrasound Guided Tunneled Central Venous Access in children: A Randomized Controlled Study.

Soundappan, SSV Lam, L

Cass, DT Karpelowsky, J

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Publisher:: Elsevier
Publication Type:: Journal Article
Citation:: Journal of Surgical Research, 2021, 260, pp. 284-292
Issue Date:: 2021-04

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Field	Value	Language
dc.contributor.author	Soundappan, SSV
dc.contributor.author	Lam, L https://orcid.org/0000-0001-6183-6854
dc.contributor.author	Cass, DT
dc.contributor.author	Karpelowsky, J
dc.date.accessioned	2022-02-02T05:01:50Z
dc.date.available	2020-11-15
dc.date.available	2022-02-02T05:01:50Z
dc.date.issued	2021-04
dc.identifier.citation	Journal of Surgical Research, 2021, 260, pp. 284-292
dc.identifier.issn	0022-4804
dc.identifier.issn	1095-8673
dc.identifier.uri	http://hdl.handle.net/10453/154124
dc.description.abstract	BACKGROUND: The purpose of this study was to compare open insertion to ultrasound guided percutaneous insertion of central access catheters performed in a tertiary pediatric hospital in terms of its safety and complication rates. METHODS: This was an ethics approved prospective randomized trial of children under 16 y 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. RESULTS: A total of 108 patients were analyzed. Sixty-four were male. Right internal jugular vein was accessed in 97. Eighty-one lines were double lumen, 23 implantable access devices, and the rest were single lumen catheters. More than one needle puncture was needed in 22% of the cases but there were no conversions in the ultrasound group. Twelve patients needed more than one insertion to achieve optimal position of the tip. Eleven patients had immediate and late complications. Percutaneous lines lasted 45 d 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. CONCLUSIONS: 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.
dc.format	Print-Electronic
dc.language	eng
dc.publisher	Elsevier
dc.relation.ispartof	Journal of Surgical Research
dc.relation.isbasedon	10.1016/j.jss.2020.11.065
dc.rights	info:eu-repo/semantics/closedAccess
dc.subject	1103 Clinical Sciences
dc.subject.classification	Surgery
dc.subject.mesh	Adolescent
dc.subject.mesh	Catheterization, Central Venous
dc.subject.mesh	Central Venous Catheters
dc.subject.mesh	Child
dc.subject.mesh	Child, Preschool
dc.subject.mesh	Female
dc.subject.mesh	Hospitals, Pediatric
dc.subject.mesh	Humans
dc.subject.mesh	Incidence
dc.subject.mesh	Infant
dc.subject.mesh	Infant, Newborn
dc.subject.mesh	Male
dc.subject.mesh	Medical Errors
dc.subject.mesh	Operative Time
dc.subject.mesh	Outcome Assessment, Health Care
dc.subject.mesh	Postoperative Complications
dc.subject.mesh	Prospective Studies
dc.subject.mesh	Reoperation
dc.subject.mesh	Single-Blind Method
dc.subject.mesh	Ultrasonography, Interventional
dc.subject.mesh	Adolescent
dc.subject.mesh	Catheterization, Central Venous
dc.subject.mesh	Central Venous Catheters
dc.subject.mesh	Child
dc.subject.mesh	Child, Preschool
dc.subject.mesh	Female
dc.subject.mesh	Hospitals, Pediatric
dc.subject.mesh	Humans
dc.subject.mesh	Incidence
dc.subject.mesh	Infant
dc.subject.mesh	Infant, Newborn
dc.subject.mesh	Male
dc.subject.mesh	Medical Errors
dc.subject.mesh	Operative Time
dc.subject.mesh	Outcome Assessment, Health Care
dc.subject.mesh	Postoperative Complications
dc.subject.mesh	Prospective Studies
dc.subject.mesh	Reoperation
dc.subject.mesh	Single-Blind Method
dc.subject.mesh	Ultrasonography, Interventional
dc.subject.mesh	Humans
dc.subject.mesh	Postoperative Complications
dc.subject.mesh	Ultrasonography, Interventional
dc.subject.mesh	Catheterization, Central Venous
dc.subject.mesh	Reoperation
dc.subject.mesh	Incidence
dc.subject.mesh	Prospective Studies
dc.subject.mesh	Single-Blind Method
dc.subject.mesh	Adolescent
dc.subject.mesh	Child
dc.subject.mesh	Child, Preschool
dc.subject.mesh	Infant
dc.subject.mesh	Infant, Newborn
dc.subject.mesh	Hospitals, Pediatric
dc.subject.mesh	Medical Errors
dc.subject.mesh	Female
dc.subject.mesh	Male
dc.subject.mesh	Central Venous Catheters
dc.subject.mesh	Operative Time
dc.subject.mesh	Outcome Assessment, Health Care
dc.title	Open Versus Ultrasound Guided Tunneled Central Venous Access in children: A Randomized Controlled Study.
dc.type	Journal Article
utslib.citation.volume	260
utslib.location.activity	United States
utslib.for	1103 Clinical Sciences
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
pubs.organisational-group	/University of Technology Sydney/Strength - CHSP - Health Services and Practice
utslib.copyright.status	closed_access	*
pubs.consider-herdc	false
dc.date.updated	2022-02-02T05:01:47Z
pubs.publication-status	Published
pubs.volume	260

Abstract:

BACKGROUND: The purpose of this study was to compare open insertion to ultrasound guided percutaneous insertion of central access catheters performed in a tertiary pediatric hospital in terms of its safety and complication rates. METHODS: This was an ethics approved prospective randomized trial of children under 16 y 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. RESULTS: A total of 108 patients were analyzed. Sixty-four were male. Right internal jugular vein was accessed in 97. Eighty-one lines were double lumen, 23 implantable access devices, and the rest were single lumen catheters. More than one needle puncture was needed in 22% of the cases but there were no conversions in the ultrasound group. Twelve patients needed more than one insertion to achieve optimal position of the tip. Eleven patients had immediate and late complications. Percutaneous lines lasted 45 d 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. CONCLUSIONS: 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.

Please use this identifier to cite or link to this item:

http://hdl.handle.net/10453/154124