GKD Anest Yoð Bak Dern Derg. 2019; 25(3): 160-166 | DOI: 10.5222/GKDAD.2019.16056

The comparison of anatomical description and ultrasound-guided percutaneous central venous catheter insertion methods single center experience

Yahya Yýldýz¹, Mustafa Özer Ulukan², Emir Cantürk³, Yaþar Gökhan Gül¹, Korhan Erkanli², Yavuz Demiraran¹, Murat Uðurlucan², Halil Türkoðlu^2
1Medipol University, Medical Faculty, Department of Anesthesiology and Reanimation, Istanbul, Turkey
²Medipol University, Medical Faculty, Department Of Cardivascular Surgery, Istanbul, Turkey
³Bezmialem University, Medical Faculty, Department Of Cardivascular Surgery, Istanbul, Turkey

INTRODUCTION: With the widespread use of ultrasound by the pediatric cardiac anesthesiologist, the number of successful interventions with time and material saving increased and complications decreased. In this study, we compared the methods of insertion of two different methods, anatomic definition (AD) and ultrasonography (US) with percutaneous central venous catheter (CVC).
METHODS: A total of 293 cases, under 10 kg, randomly, retrospectively; AD (n=151) and US (n=142) were divided into two groups. The CVC was inserted into the right/left internal jugular vein (IJ), the right/left femoral vein (FV), and the right/left subclavian vein (SCV). Compared parameters: demographics, catheter insertion site, procedures, durations, number of surgical catheter insertion and complications.
RESULTS: Demographic data of the groups; in age (1 day-4.5 years), weight (560 gr-10 kg), height (23-103 cm) and gender was no difference (p≥0.05). CVC insertion in %: right/left IJ, right/left FV, right SCV, surgical femoral vein/right atrium; In the AD at 82/6/6/2/2/2, in US 89/9/1/0/0/0 (p<0,05). The number of CVC interventions were 1-26 (6.7±17.7) times in the AD group and 1-4 (1.23±0.5) in the US group (p<0.05). The duration (minute) of CVC insertion was 16-231 (45.2±47.5) in the AD group and 11-82 (16.1±13.8) in the US group (p<0.05). Complications was: bleeding, hematoma, circulatory disorder, nerve damage, prolonged hospitalization, mortality in %; AD 11/9/7/3/4/1, US 1/2/0/0/0/0 (p<0.05).
DISCUSSION AND CONCLUSION: Catheterization in pediatric cardiac anesthesia can be done by anatomical description or ultrasound; but with ultrasound guidance; We believe that it causes a decrease in the complications while leading to an improvement in time and successful intervention.

Keywords: Central venous catheter, anatomic description, ultrasonography, newborn, perioperative complications.

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Çocuklara anatomik tarif ve ultrasonografi eþliðinde perkütan santral venoz kateter takýlmasý yöntemlerinin karþýlaþtýrýlmasý tek merkez deneyimi

Yahya Yýldýz¹, Mustafa Özer Ulukan², Emir Cantürk³, Yaþar Gökhan Gül¹, Korhan Erkanli², Yavuz Demiraran¹, Murat Uðurlucan², Halil Türkoðlu^2
1Medipol Üniversitesi, Týp Fakültesi Hastanesi, Anesteziyoloji ve Reanimasyon Servisi, Ýstanbul, Türkiye
²Medipol Üniversitesi, Týp Fakültesi Hastanesi, Kalp Damar Cerrahisi, Ýstanbul, Türkiye
³Bemialem Üniversitesi, Týp Fakültesi Hastanesi, Kalp Damar Cerrahisi, Ýstanbul, Türkiye

GÝRÝÞ ve AMAÇ: Pediatrik kardiyak anestezist tarafýndan ultrasonun yaygýn olarak kullanýlmasý ile zaman ve malzeme tasarrufu ile birlikte baþarýlý giriþim sayýsý artmýþ, komplikasyonlarda da azalma olmuþtur. Bu çalýþmada çocuklara iki farklý yöntem olan anatomik tarif (AT) ve Ultrasonografi (US) eþliðinde perkutan santral venöz kateter (SVK) takýlmasý yöntemlerini karþýlaþtýrdýk.
YÖNTEM ve GEREÇLER: On kilogramýn altýnda, toplam 293 vaka, rasgele, retrospektif olarak; AT (n=151) ve US (n=142) eþliðinde kateterizasyon yapýlanlar olarak iki gruba ayrýldý. SVK sað/sol internal juguler ven (ÝJ), sað/sol femoral ven (FV) ve sað/sol subklaviyan venden (SKV) takýldý. Karþýlaþtýrýlan parametreler: demografik veriler, kateterin takýldýðý yer, giriþim sayýsý, iþlemi bitirme süresi, cerrahi kateter takýlma sayýsý, komplikasyonlar idi.
BULGULAR: Gruplarýn demografik verileri; yaþ (1 gün- 4.5 yaþ), aðýrlýk (560 gr-10 kg), boy (23-103 cm) ve cinsiyetleri arasýnda fark yoktu (p>0,05). SVK takýldýðý yerler sýrasý ile % olarak: sað ÝJ/sol ÝJ/sað FV/ sol FV/ sað SKV /cerrahi femoral ven/sað atriyum; AT de 82/6/6/2/2/2, US’de 89/9/1/0/0/0 (p<0,05). SVK giriþim sayýsý: AT grubunda 1-26 (6,7±17,7) kez ve US grubunda ise 1-4 (1,23 ±0,5) kez idi (p<0,05). SVK takma süresi: AT grubunda 16-231 (45,2±47,5) dakika ve US grubunda ise 11-82 (16,1±13,8) dakika idi (p<0,05). Komplikasyonlar: kanama, hematom, dolaþým bozukluðu, sinir hasarý, uzamýþ yatýþ, mortalite sýrasý ile % olarak; AT’de 11/9/7/3/4/1, US’de %1/2/0/0/0/0 idi (p<0,05).
TARTIÞMA ve SONUÇ: Pediatrik kardiyak anestezide kateterizasyonlar anatomik tarif veya ultrason eþliðinde yapýlabilir; fakat ultrason eþliðinde yapýlmasý; zaman ve baþarýlý giriþim yönünden iyileþmeye neden olurken, komplikasyonlarda da azalmaya neden olacaðý kanýsýndayýz.

Anahtar Kelimeler: Santral venöz kateter, anatomik tarif, ultrasonografi, yenidoðan, perioperatif komplikasyon

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