A review of 5434 percutaneous pediatric central venous catheters inserted by anesthesiologists
Summary Objective To review the results of an anesthesiologist led pediatric percutaneous central venous access service. Methods Prospective data on percutaneous pediatric central venous catheter (CVC) insertions were collected over 22 years. Data included age, gender, weight, previous central CVCs,...
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| Veröffentlicht in: | Pediatric anesthesia 2013-11, Vol.23 (11), p.974-979 |
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| container_title | Pediatric anesthesia |
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| creator | Malbezin, Serge Gauss, Tobias Smith, Ian Bruneau, Beatrice Mangalsuren, Nyamjargal Diallo, Thierno Skhiri, Alia Nivoche, Yves Dahmani, Souhayl Brasher, Christopher |
| description | Summary
Objective
To review the results of an anesthesiologist led pediatric percutaneous central venous access service.
Methods
Prospective data on percutaneous pediatric central venous catheter (CVC) insertions were collected over 22 years. Data included age, gender, weight, previous central CVCs, venous thromboses, investigations for great vein patency, type of CVC, external diameter, previous CVC insertions, intended use, operator identity, and the vein into which the CVC was inserted. The default technique was internal jugular vein cannulation using landmark technique (LT). Complication was defined as the following: failure to cannulate any vein, hemothorax, pneumothorax, right atrial perforation, extravenous wire positioning or CVC position and whether the patient was taken back to theater for CVC repositioning.
Results
Five thousand four hundred and thirty‐four percutaneous CVC insertion procedures were performed on 3954 patients. One‐third involved children |
| doi_str_mv | 10.1111/pan.12184 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1443397898</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1443397898</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4924-a11931b46d55e2562696a327ce79866776a28ae6802140d6da6abb0434665c163</originalsourceid><addsrcrecordid>eNp1kEtP3DAUhS3UCihl0T9QWeqmXQT8vImXI1Sg6gioymuF5Th3WtNMMtgJdP59TQMsKtUb-9rfOTo-hLzjbI_ntb9y3R4XvFIbZJsrYIXRRrzKZ651oUHpLfImpVvGuBQgNsmWkKCNArFNbmY04n3AB9ovqFZS0RVGPw6uw35MeWiCG2Lw1GM3RNfSe-weH7wbfuKAMdHQJYwDNrRe06xK-T6Fvu1_hDSkt-T1wrUJd5_2HXJx-Pn84LiYnx59OZjNC6-MUIXj3EheK2i0RqFBgAEnRemxNBVAWYITlUOomOCKNdA4cHXNclwA7TnIHfJx8l3F_m7MIewyJI9tO_3DcqWkNGVlqox--Ae97cfY5XSZkpWRRnOWqU8T5WOfUsSFXcWwdHFtObOPpdtcuv1bembfPzmO9RKbF_K55QzsT8BDaHH9fyd7Njt5tiwmRS4Rf78oXPxloZSltlcnR3Yuvn29vL4-tt_lH4lkmSY</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1438939510</pqid></control><display><type>article</type><title>A review of 5434 percutaneous pediatric central venous catheters inserted by anesthesiologists</title><source>MEDLINE</source><source>Wiley Online Library Journals Frontfile Complete</source><creator>Malbezin, Serge ; Gauss, Tobias ; Smith, Ian ; Bruneau, Beatrice ; Mangalsuren, Nyamjargal ; Diallo, Thierno ; Skhiri, Alia ; Nivoche, Yves ; Dahmani, Souhayl ; Brasher, Christopher</creator><contributor>Hammer, Greg ; Hammer, Greg</contributor><creatorcontrib>Malbezin, Serge ; Gauss, Tobias ; Smith, Ian ; Bruneau, Beatrice ; Mangalsuren, Nyamjargal ; Diallo, Thierno ; Skhiri, Alia ; Nivoche, Yves ; Dahmani, Souhayl ; Brasher, Christopher ; Hammer, Greg ; Hammer, Greg</creatorcontrib><description>Summary
Objective
To review the results of an anesthesiologist led pediatric percutaneous central venous access service.
Methods
Prospective data on percutaneous pediatric central venous catheter (CVC) insertions were collected over 22 years. Data included age, gender, weight, previous central CVCs, venous thromboses, investigations for great vein patency, type of CVC, external diameter, previous CVC insertions, intended use, operator identity, and the vein into which the CVC was inserted. The default technique was internal jugular vein cannulation using landmark technique (LT). Complication was defined as the following: failure to cannulate any vein, hemothorax, pneumothorax, right atrial perforation, extravenous wire positioning or CVC position and whether the patient was taken back to theater for CVC repositioning.
Results
Five thousand four hundred and thirty‐four percutaneous CVC insertion procedures were performed on 3954 patients. One‐third involved children <1 year of age (n = 1823: 34%). Five thousand one hundred and twenty‐five CVCs (95.3%) were inserted into internal jugular veins. The majority were tunneled CVCs (n = 5190: 96.2%). The perioperative complication rate was 1.3%. Successful cannulation occurred in 99.5% of patients. Failure was more likely in children <3 kg, during large bore hemodialysis CVC insertions and during the first 4 years of the service – the latter suggesting a learning curve. Ninety‐nine percent of CVCs were inserted using LTs.
Conclusion
This study demonstrates a high success rate and low complication rate during pediatric percutaneous internal jugular vein CVC insertions by trained anesthesiologists using LTs. Smaller children, hemodialysis CVCs, and the team's learning curve were identified as risk factors for insertion failure.</description><identifier>ISSN: 1155-5645</identifier><identifier>EISSN: 1460-9592</identifier><identifier>DOI: 10.1111/pan.12184</identifier><identifier>PMID: 23659462</identifier><language>eng</language><publisher>France: Blackwell Publishing Ltd</publisher><subject>Anatomic Landmarks ; anesthesiologist ; Anesthesiology ; Catheterization, Central Venous - adverse effects ; Catheterization, Central Venous - methods ; central venous access ; central venous catheterization ; Central Venous Catheters - adverse effects ; Child, Preschool ; Clinical Competence ; complications ; Data Collection ; Equipment Design ; Female ; Humans ; Infant ; Infant, Newborn ; jugular vein ; Learning Curve ; Male ; Parenteral Nutrition - methods ; pediatrics ; percutaneous ; Physicians ; Supine Position ; Treatment Failure ; Treatment Outcome ; Vascular Access Devices</subject><ispartof>Pediatric anesthesia, 2013-11, Vol.23 (11), p.974-979</ispartof><rights>2013 John Wiley & Sons Ltd</rights><rights>2013 John Wiley & Sons Ltd.</rights><rights>Copyright © 2013 John Wiley & Sons Ltd</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4924-a11931b46d55e2562696a327ce79866776a28ae6802140d6da6abb0434665c163</citedby><cites>FETCH-LOGICAL-c4924-a11931b46d55e2562696a327ce79866776a28ae6802140d6da6abb0434665c163</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fpan.12184$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fpan.12184$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27903,27904,45553,45554</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23659462$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Hammer, Greg</contributor><contributor>Hammer, Greg</contributor><creatorcontrib>Malbezin, Serge</creatorcontrib><creatorcontrib>Gauss, Tobias</creatorcontrib><creatorcontrib>Smith, Ian</creatorcontrib><creatorcontrib>Bruneau, Beatrice</creatorcontrib><creatorcontrib>Mangalsuren, Nyamjargal</creatorcontrib><creatorcontrib>Diallo, Thierno</creatorcontrib><creatorcontrib>Skhiri, Alia</creatorcontrib><creatorcontrib>Nivoche, Yves</creatorcontrib><creatorcontrib>Dahmani, Souhayl</creatorcontrib><creatorcontrib>Brasher, Christopher</creatorcontrib><title>A review of 5434 percutaneous pediatric central venous catheters inserted by anesthesiologists</title><title>Pediatric anesthesia</title><addtitle>Paediatr Anaesth</addtitle><description>Summary
Objective
To review the results of an anesthesiologist led pediatric percutaneous central venous access service.
Methods
Prospective data on percutaneous pediatric central venous catheter (CVC) insertions were collected over 22 years. Data included age, gender, weight, previous central CVCs, venous thromboses, investigations for great vein patency, type of CVC, external diameter, previous CVC insertions, intended use, operator identity, and the vein into which the CVC was inserted. The default technique was internal jugular vein cannulation using landmark technique (LT). Complication was defined as the following: failure to cannulate any vein, hemothorax, pneumothorax, right atrial perforation, extravenous wire positioning or CVC position and whether the patient was taken back to theater for CVC repositioning.
Results
Five thousand four hundred and thirty‐four percutaneous CVC insertion procedures were performed on 3954 patients. One‐third involved children <1 year of age (n = 1823: 34%). Five thousand one hundred and twenty‐five CVCs (95.3%) were inserted into internal jugular veins. The majority were tunneled CVCs (n = 5190: 96.2%). The perioperative complication rate was 1.3%. Successful cannulation occurred in 99.5% of patients. Failure was more likely in children <3 kg, during large bore hemodialysis CVC insertions and during the first 4 years of the service – the latter suggesting a learning curve. Ninety‐nine percent of CVCs were inserted using LTs.
Conclusion
This study demonstrates a high success rate and low complication rate during pediatric percutaneous internal jugular vein CVC insertions by trained anesthesiologists using LTs. Smaller children, hemodialysis CVCs, and the team's learning curve were identified as risk factors for insertion failure.</description><subject>Anatomic Landmarks</subject><subject>anesthesiologist</subject><subject>Anesthesiology</subject><subject>Catheterization, Central Venous - adverse effects</subject><subject>Catheterization, Central Venous - methods</subject><subject>central venous access</subject><subject>central venous catheterization</subject><subject>Central Venous Catheters - adverse effects</subject><subject>Child, Preschool</subject><subject>Clinical Competence</subject><subject>complications</subject><subject>Data Collection</subject><subject>Equipment Design</subject><subject>Female</subject><subject>Humans</subject><subject>Infant</subject><subject>Infant, Newborn</subject><subject>jugular vein</subject><subject>Learning Curve</subject><subject>Male</subject><subject>Parenteral Nutrition - methods</subject><subject>pediatrics</subject><subject>percutaneous</subject><subject>Physicians</subject><subject>Supine Position</subject><subject>Treatment Failure</subject><subject>Treatment Outcome</subject><subject>Vascular Access Devices</subject><issn>1155-5645</issn><issn>1460-9592</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kEtP3DAUhS3UCihl0T9QWeqmXQT8vImXI1Sg6gioymuF5Th3WtNMMtgJdP59TQMsKtUb-9rfOTo-hLzjbI_ntb9y3R4XvFIbZJsrYIXRRrzKZ651oUHpLfImpVvGuBQgNsmWkKCNArFNbmY04n3AB9ovqFZS0RVGPw6uw35MeWiCG2Lw1GM3RNfSe-weH7wbfuKAMdHQJYwDNrRe06xK-T6Fvu1_hDSkt-T1wrUJd5_2HXJx-Pn84LiYnx59OZjNC6-MUIXj3EheK2i0RqFBgAEnRemxNBVAWYITlUOomOCKNdA4cHXNclwA7TnIHfJx8l3F_m7MIewyJI9tO_3DcqWkNGVlqox--Ae97cfY5XSZkpWRRnOWqU8T5WOfUsSFXcWwdHFtObOPpdtcuv1bembfPzmO9RKbF_K55QzsT8BDaHH9fyd7Njt5tiwmRS4Rf78oXPxloZSltlcnR3Yuvn29vL4-tt_lH4lkmSY</recordid><startdate>201311</startdate><enddate>201311</enddate><creator>Malbezin, Serge</creator><creator>Gauss, Tobias</creator><creator>Smith, Ian</creator><creator>Bruneau, Beatrice</creator><creator>Mangalsuren, Nyamjargal</creator><creator>Diallo, Thierno</creator><creator>Skhiri, Alia</creator><creator>Nivoche, Yves</creator><creator>Dahmani, Souhayl</creator><creator>Brasher, Christopher</creator><general>Blackwell Publishing Ltd</general><general>Wiley Subscription Services, Inc</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>7X8</scope></search><sort><creationdate>201311</creationdate><title>A review of 5434 percutaneous pediatric central venous catheters inserted by anesthesiologists</title><author>Malbezin, Serge ; Gauss, Tobias ; Smith, Ian ; Bruneau, Beatrice ; Mangalsuren, Nyamjargal ; Diallo, Thierno ; Skhiri, Alia ; Nivoche, Yves ; Dahmani, Souhayl ; Brasher, Christopher</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4924-a11931b46d55e2562696a327ce79866776a28ae6802140d6da6abb0434665c163</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Anatomic Landmarks</topic><topic>anesthesiologist</topic><topic>Anesthesiology</topic><topic>Catheterization, Central Venous - adverse effects</topic><topic>Catheterization, Central Venous - methods</topic><topic>central venous access</topic><topic>central venous catheterization</topic><topic>Central Venous Catheters - adverse effects</topic><topic>Child, Preschool</topic><topic>Clinical Competence</topic><topic>complications</topic><topic>Data Collection</topic><topic>Equipment Design</topic><topic>Female</topic><topic>Humans</topic><topic>Infant</topic><topic>Infant, Newborn</topic><topic>jugular vein</topic><topic>Learning Curve</topic><topic>Male</topic><topic>Parenteral Nutrition - methods</topic><topic>pediatrics</topic><topic>percutaneous</topic><topic>Physicians</topic><topic>Supine Position</topic><topic>Treatment Failure</topic><topic>Treatment Outcome</topic><topic>Vascular Access Devices</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Malbezin, Serge</creatorcontrib><creatorcontrib>Gauss, Tobias</creatorcontrib><creatorcontrib>Smith, Ian</creatorcontrib><creatorcontrib>Bruneau, Beatrice</creatorcontrib><creatorcontrib>Mangalsuren, Nyamjargal</creatorcontrib><creatorcontrib>Diallo, Thierno</creatorcontrib><creatorcontrib>Skhiri, Alia</creatorcontrib><creatorcontrib>Nivoche, Yves</creatorcontrib><creatorcontrib>Dahmani, Souhayl</creatorcontrib><creatorcontrib>Brasher, Christopher</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Pediatric anesthesia</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Malbezin, Serge</au><au>Gauss, Tobias</au><au>Smith, Ian</au><au>Bruneau, Beatrice</au><au>Mangalsuren, Nyamjargal</au><au>Diallo, Thierno</au><au>Skhiri, Alia</au><au>Nivoche, Yves</au><au>Dahmani, Souhayl</au><au>Brasher, Christopher</au><au>Hammer, Greg</au><au>Hammer, Greg</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A review of 5434 percutaneous pediatric central venous catheters inserted by anesthesiologists</atitle><jtitle>Pediatric anesthesia</jtitle><addtitle>Paediatr Anaesth</addtitle><date>2013-11</date><risdate>2013</risdate><volume>23</volume><issue>11</issue><spage>974</spage><epage>979</epage><pages>974-979</pages><issn>1155-5645</issn><eissn>1460-9592</eissn><abstract>Summary
Objective
To review the results of an anesthesiologist led pediatric percutaneous central venous access service.
Methods
Prospective data on percutaneous pediatric central venous catheter (CVC) insertions were collected over 22 years. Data included age, gender, weight, previous central CVCs, venous thromboses, investigations for great vein patency, type of CVC, external diameter, previous CVC insertions, intended use, operator identity, and the vein into which the CVC was inserted. The default technique was internal jugular vein cannulation using landmark technique (LT). Complication was defined as the following: failure to cannulate any vein, hemothorax, pneumothorax, right atrial perforation, extravenous wire positioning or CVC position and whether the patient was taken back to theater for CVC repositioning.
Results
Five thousand four hundred and thirty‐four percutaneous CVC insertion procedures were performed on 3954 patients. One‐third involved children <1 year of age (n = 1823: 34%). Five thousand one hundred and twenty‐five CVCs (95.3%) were inserted into internal jugular veins. The majority were tunneled CVCs (n = 5190: 96.2%). The perioperative complication rate was 1.3%. Successful cannulation occurred in 99.5% of patients. Failure was more likely in children <3 kg, during large bore hemodialysis CVC insertions and during the first 4 years of the service – the latter suggesting a learning curve. Ninety‐nine percent of CVCs were inserted using LTs.
Conclusion
This study demonstrates a high success rate and low complication rate during pediatric percutaneous internal jugular vein CVC insertions by trained anesthesiologists using LTs. Smaller children, hemodialysis CVCs, and the team's learning curve were identified as risk factors for insertion failure.</abstract><cop>France</cop><pub>Blackwell Publishing Ltd</pub><pmid>23659462</pmid><doi>10.1111/pan.12184</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1155-5645 |
| ispartof | Pediatric anesthesia, 2013-11, Vol.23 (11), p.974-979 |
| issn | 1155-5645 1460-9592 |
| language | eng |
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| source | MEDLINE; Wiley Online Library Journals Frontfile Complete |
| subjects | Anatomic Landmarks anesthesiologist Anesthesiology Catheterization, Central Venous - adverse effects Catheterization, Central Venous - methods central venous access central venous catheterization Central Venous Catheters - adverse effects Child, Preschool Clinical Competence complications Data Collection Equipment Design Female Humans Infant Infant, Newborn jugular vein Learning Curve Male Parenteral Nutrition - methods pediatrics percutaneous Physicians Supine Position Treatment Failure Treatment Outcome Vascular Access Devices |
| title | A review of 5434 percutaneous pediatric central venous catheters inserted by anesthesiologists |
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