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01-03-2018 | Original Article

Supraclavicular catheterization of the brachiocephalic vein: a way to prevent or reduce catheter maintenance-related complications in children

Authors: Flora Habas, Julien Baleine, Christophe Milési, Clémentine Combes, Marie-Noëlle Didelot, Sara Romano-Bertrand, Delphine Grau, Sylvie Parer, Catherine Baud, Gilles Cambonie

Published in: European Journal of Pediatrics | Issue 3/2018

Abstract

Placement of a central venous catheter (CVC) in the brachiocephalic vein (BCV) via the ultrasound (US)-guided supraclavicular approach was recently described in children. We aimed to determine the CVC maintenance-related complications at this site compared to the others (i.e., the femoral, the subclavian, and the jugular). We performed a retrospective data collection of prospectively registered data on CVC in young children hospitalized in a pediatric intensive care unit (PICU) during a 4-year period (May 2011 to May 2015). The primary outcome was a composite of central line-associated bloodstream infection (CLABSI) and deep-vein thrombosis (CLAT) according to the CVC site. Two hundred and twenty-five children, with respective age and weight of 7.1 (1.3–40.1) months and 7.7 (3.6–16) kg, required 257 CVCs, including 147 (57.2%) inserted in the BCV. The risk of the primary outcome was lower in the BCV than in the other sites (5.4 vs 16.4%; OR: 0.29; 95% CI: 0.12–0.70; p = 0.006). CLABSI incidence density rate (2.8 vs 8.96 per 1000 catheter days, p < 0.001) and CLAT incidence rate (2.7 vs 10%, p = 0.016) were also lower at this site. Conclusion: BCV catheterization via the US-guided supraclavicular approach may decrease CVC maintenance-related complications in children hospitalized in a PICU.

What is Known:

• Placement of a central venous catheter (CVC) in children is associated with mechanical risks during insertion, and with infectious and thrombotic complications during its maintenance.

• Ultrasound (US)-guided supraclavicular catheterization of the brachiocephalic vein (BCV) is feasible in infants and children.

What is New:

• This observational study suggested that BCV catheterization via the US-guided supraclavicular approach was associated with a lower risk of CVC insertion and maintenance-related complications, compared with the other catheterization sites.

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Title: Supraclavicular catheterization of the brachiocephalic vein: a way to prevent or reduce catheter maintenance-related complications in children
Authors: Flora Habas
Julien Baleine
Christophe Milési
Clémentine Combes
Marie-Noëlle Didelot
Sara Romano-Bertrand
Delphine Grau
Sylvie Parer
Catherine Baud
Gilles Cambonie
Publication date: 01-03-2018
Publisher: Springer Berlin Heidelberg
Published in: European Journal of Pediatrics / Issue 3/2018
Print ISSN: 0340-6199
Electronic ISSN: 1432-1076
DOI: https://doi.org/10.1007/s00431-017-3082-x

At a glance: The STEP trials

Springer Medicine

Supraclavicular catheterization of the brachiocephalic vein: a way to prevent or reduce catheter maintenance-related complications in children

Abstract

At a glance: The STEP trials

Springer Medicine

Abstract

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