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Ultrasound guidance allows faster peripheral IV cannulation in children under 3 years of age with difficult venous access: a prospective randomized study
Author(s) -
Benkhadra Mehdi,
Collig Mathieu,
Fournel Isabelle,
Oeuvrard Christian,
Rollin Patricia,
Perrin Murielle,
Volot François,
Girard Claude
Publication year - 2012
Publication title -
pediatric anesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.704
H-Index - 82
eISSN - 1460-9592
pISSN - 1155-5645
DOI - 10.1111/j.1460-9592.2012.03830.x
Subject(s) - medicine , peripheral , ultrasound , prospective cohort study , randomized controlled trial , venous access , surgery , radiology , catheter
Summary Objectives: Ultrasound‐guided peripheral venous access (USG‐PIVA) presents many advantages over the reference ‘blind’ technique in both adults and children in emergency situations. Aim: To compare USG‐PIVA with the blind technique in children <3 years undergoing general anesthesia. Methods: After obtaining the approval of the ethics committee and informed consent from the parents, we included all children <3 years scheduled to undergo general anesthesia [surgery, magnetic resonance imaging (MRI)], who presented difficult venous access. The children were randomized into two groups: the US group (USG‐PIVA) and the B group (blind). The primary endpoint was time to cannulation (from tourniquet placement to successful IV cannulation), compared between USG‐PIVA group and B group by intention‐to‐treat analysis. Secondary outcomes were success rate at the first puncture, number of punctures, and diameter of the catheters. Cannulations requiring >15 min were considered as failures. In case of failure in group B, USG‐PIVA was attempted for a further 15 min. Results: Twenty children were included in each group. Groups were comparable for sex, age, and BMI. Significant differences were observed in median time to cannulation (63.5 s vs 420.5 s, USG‐PIVA vs B respectively, P < 0.001); median number of punctures (1 vs 2.5, USG‐PIVA vs B, P = 0.004); and success rate at first cannulation (85% vs 35%, USG‐PIVA vs B, P = 0.0012). In contrast, overall success rate did not differ significantly between groups (90% vs 85%, USG‐PIVA vs B, P = 0.63). Conclusions: Ultrasound‐guided peripheral venous access leads to faster peripheral IV access and should therefore be recommended in children presenting with difficult venous access.