A comparison of different approaches of percutaneous central venous catheterization in children less than six years of age / 中华麻醉学杂志

ABSTRACT

Objective To evaluate the feasibility of catheterization of subclavian vein via supra-clavicular puncture in children less than six years of age, in comparison with subclavian vein catheterization via infraclavicular puncture and cannulation of internal jugular vein (IJV) from a high medial approach. Methods One hundred and eighty children (104 male, 76 female) aged 15 d-6 yr, undergoing major surgery were randomly divided into 3 equal groups of 60 patients group I subclavian vein catheterization via supra-clavicular puncture; group Ⅱ subclavian vein catheterization via infra-clavicular puncture and group Ⅲ IJV catheterization from a high medial approach. (1) The overall success rate of puncture, (2) the success rate of puncture at first attempt, (3) the success rate of cannulation, (4) the duration from beginning of puncture to aspiration of blood, (5) the duration from the beginning of puncture to successful cannulation and (6) complication were recorded. Chest X-ray was taken in 30 patients in group I for confirmation of the position of catheter in subclavian vein. Results (1) The overall success rate of puncture was 100% and the success rate of puncture at first attempt was 86.67% in group I significantly higher than those in group Ⅱ (91.96% and 51.67%) and group Ⅲ (93.33% and 58.33%) (P