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Effects of vascular morphological features and ultrasound-guided vascular cannulation techniques on the success of femoral artery catheterisation in newborns

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Abstract

Ultrasound-guided vascular access is a technique that can increase safety as well as technical and procedural success when performing invasive cardiovascular procedures. The aim of this study was to evaluate the effects of two cannulation techniques and vascular morphological properties on the success of femoral artery catheterisation in neonatal patients. We recruited 65 consecutive patients requiring femoral artery catheterisation and randomly divided them into two groups: Group 1, in-plane technique (n = 31) and Group 2, out-of-plane technique (n = 34). We compared the preparation duration, puncture duration, number of punctures, number of arterial punctures, number of unsuccessful interventions, hematoma incidence and vascular morphological characteristics between the groups. The mean age of Group 1 was 17.16 ± 7.04 days, and the mean age of Group 2 was 17.20 ± 7.40 days, with no difference observed between the groups (p > 0.05). Four patients in Group 1 and nine patients in Group 2 developed hematoma (p = 0.172). Hematoma was strongly correlated with the number of venous punctures (r = 0.632; p = 0.001) and the number of needle advancements (r = 0.415; p = 0.001). In terms of artery–vein position, patients whose artery overlapped the vein by > 50% required clearly longer artery cannulation durations than the other patients (p < 0.001). Although the in-plane technique has a steep learning curve, it was found superior in terms of procedure-related factors such as the number of trials, the incidence of hematoma and arterial puncture counts, as it offers advantages such as the ability to evaluate the lumen and a better control of the needle advancement direction.

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References

  1. Ang H, Veldman A, Lewis A, Carse E, Wong FY. Procedural training opportunities for basic pediatric trainees during a 6-month rotation in a level III perinatal centre in Australia. J Matern Fetal Neonatal Med. 2012;25(11):2428–31.

    Article  Google Scholar 

  2. Bhatia N, Sivaprakasam J, Allford M, Guruswamy V. The relative position of femoral artery and vein in children under general anesthesia–an ultrasound-guided observational study. Paediatr Anaesth. 2014;24(11):1164–8.

    Article  Google Scholar 

  3. National Institute for Clinical Excellence. Acutely ill patients in hospital overview. www.nice.org.uk. Accessed May, 2019

  4. Troianos CA, Hartman GS, Glas KE, Skubas NJ, Eberhardt RT, Walker JD, Reeves ST, Councils on Intraoperative Echocardiography, and Vascular Ultrasound of the American Society of Echocardiography; Society of Cardiovascular Anesthesiologists. Special articles: guidelines for performing ultrasound guided vascular cannulation: recommendations of the American Society of Echocardiography and the Society of Cardiovascular Anesthesiologists. Anesth Analg. 2012;114(1):46–72.

    Article  Google Scholar 

  5. American Institute of Ultrasound in Medicine. AIUM practice guideline for the use of ultrasound to guide vascular access, procedures. J Ultrasound Med. 2013;32(1):191–21515.

    Article  Google Scholar 

  6. Berk D, Gurkan Y, Kus A, Ulugol H, Solak M, Toker K. Ultrasound-guided radial arterial cannulation: long axis/in-plane versus short axis/out-of-plane approaches? J Clin Monit Comput. 2013;27(3):319–24.

    Article  Google Scholar 

  7. Warkentine FH, Clyde Pierce M, Lorenz D, Kim IK. The anatomic relationship of femoral vein to femoral artery in euvolemic pediatric patients by ultrasonography: implications for pediatric femoral central venous access. Acad Emerg Med. 2008;15(5):426–30.

    Article  Google Scholar 

  8. Hopkins JW, Warkentine F, Gracely E, Kim IK. The anatomic relationship between the common femoral artery and common femoral vein in frog leg position versus straight leg position in pediatric patients. Acad Emerg Med. 2009;16(7):579–84.

    Article  Google Scholar 

  9. Bruzoni M, Slater BJ, Wall J, St Peter SD, Dutta S. A prospective randomized trial of ultrasound-vs landmark-guided central venous access in the pediatric population. J Am Coll Surg. 2013;216(5):939–43.

    Article  Google Scholar 

  10. Suk EH, Lee KY, Kweon TD, Jang YH, Bai SJ. Ultrasonographic evaluation of the femoral vein in anaesthetised infants and young children. Anesthesia. 2010;65(9):895–8.

    Article  CAS  Google Scholar 

  11. Sethi S, Maitra S, Saini V, Samra T, Malhotra SK. Comparison of short-axis out-of-plane versus long-axis in-plane ultrasound-guided radial arterial cannulation in adult patients: a randomized controlled trial. J Anesth. 2017;31(1):89–94.

    Article  Google Scholar 

  12. Kayashima K, Ueki M, Kinoshita Y. Ultrasonic analysis of the anatomical relationships between vertebral arteries and internal jugular veins in children. Paediatr Anaesth. 2012;22(9):854–8.

    Article  Google Scholar 

  13. Kanter RK, Gorton JM, Palmieri K, Tompkins JM, Smith F. Anatomy of femoral vessels in infants and guidelines forvenous catheterization. Pediatrics. 1989;83(6):1020–2.

    CAS  PubMed  Google Scholar 

  14. Aouad MT, Kanazi GE, Abdallah FW, Moukaddem FH, Turbay MJ, Obeid MY, Siddik-Sayyid SM. Femoral vein cannulation performed by residents: a comparison between ultrasound guided and landmark technique in infants and children undergoing cardiac surgery. Anesth Analg. 2010;111(3):724–8.

    Article  Google Scholar 

  15. Song IK, Choi JY, Lee JH, Kim EH, Kim HJ, Kim HS, Kim JT. Short-axis/out-of-plane or long-axis/in-plane ultrasound-guided arterial cannulation in children: a randomised controlled trial. Eur J Anaesthesiol. 2016;33(1):522–7.

    Article  Google Scholar 

  16. Lv Y, Liu H, Yu P, Wang G, Liu M, Li Y, Wang H, Yu K, Wang C. Evaluating the long-, short-, and oblique-axis approaches for ultrasound-guided vascular access cannulation. J Ultrasound Med. 2019;38(2):347–55.

    Article  Google Scholar 

  17. Gao YB, Yan JH, Ma JM, Liu XN, Dong JY, Sun F, Tang LW, Li J. Effects of long axis in-plane vs short axis out-of-plane techniques during ultrasound-guided vascular access. Am J Emerg Med. 2016;34(5):778–83.

    Article  Google Scholar 

  18. French JLH, Raine-Fenning NJ, Hardman JG, Bedforth NM. Pitfalls of ultrasound guided vascular access: the use of three/four-dimensional ultrasound. Anaesthesia. 2008;63(8):806–13.

    Article  CAS  Google Scholar 

  19. Blaivas M, Brannam L, Fernandez E. Short-axis versus long-axis approaches for teaching ultrasound-guided vascular access on a new inanimate model. Acad Emerg Med. 2003;10(12):1307–11.

    Article  Google Scholar 

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Correspondence to Omer Faruk Boran.

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Boran, O.F., Urfalıoglu, A., Arslan, M. et al. Effects of vascular morphological features and ultrasound-guided vascular cannulation techniques on the success of femoral artery catheterisation in newborns. J Clin Monit Comput 34, 607–614 (2020). https://doi.org/10.1007/s10877-020-00490-2

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