Short-axis out-of-plane approach versus oblique-axis approach for ultrasound-guided internal jugular venous catheterization in infants.. | ||
| Egyptian Journal of Anaesthesia | ||
| Volume 41, Issue 1, 2025, Pages 1-8 PDF (705.79 K) | ||
| Document Type: Original Article | ||
| DOI: 10.21608/egja.2025.395475.1131 | ||
| Authors | ||
| Tarek Samir Shabana* 1; Engy Yassa Beshay2; Oliver Morad Shehata2; Thabet Aziz Botros2 | ||
| 1Assistant professor of Anaesthesia, Intensive Care, and pain management- Faculty of Medicine, Ain Shams University, Cairo, Egypt. | ||
| 2Department of Anesthesiology Intensive Care and Pain Management, Faculty of Medicine, Ain Shams University, Cairo, Egypt. | ||
| Abstract | ||
| Background Central venous catheter (CVC) insertion in infants is a challenging procedure that requires advanced skills. The oblique-axis (OAX) approach for ultrasound (US)-guided CVC insertion combines the advantages of short-axis (SAX) and long-axis approaches, as it allows follow-up of the needle tip and good orientation with the surrounding structures. This study compared US-guided SAX and OAX approaches for internal jugular vein (IJV) catheterization in infants. Methods This prospective randomized controlled study was conducted in infants who required CVC insertion through the right IJV in the OR. Fifty infants were randomized into SAX and OAX groups based on the approach used. The primary outcome was the incidence of posterior vein wall puncture (PVWP). The secondary outcomes included other mechanical complications, first-attempt success rate, number of needle redirections, time to flash, and rate of unsuccessful cannulation. Results The incidence of PVWP was significantly higher in the SAX group (52%) than in the OAX group (12%) (p=0.005). Flash time was significantly longer in the SAX group (24.52 ± 3.50 s) than in the OAX group (12.84 ± 2.17 s). The first successful attempt rate was non-significantly higher in the OAX group (76%) than in the SAX group (68%). Demographic data, incidence of other complications, number of needle redirections, and rate of unsuccessful cannulations were comparable between the groups. Conclusion The OAX approach for US-guided CVC in infants was associated with a lower incidence of PVWP and shorter time to flash than the SAX approach. | ||
| Keywords | ||
| Central venous catheter; Infants; Oblique axis; Short axis; Ultrasound | ||
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