Comparison of ultrasonographic guided internal jugular vein subclavian vein and peripheral inserted central catheterization in pediatric patients

Objectives: Central venous catheterization is a common procedure in intensive care units and operating rooms. Central venous catheterization is generally used for parenteral rapid fluid replacement, drug administration, parenteral nutrition and invasive monitoring of cardiac parameters. The main veins used for central venous catheterization are internal jugular vein, subclavian vein. Central venous catheters inserted through peripheral veins (femoral, external jugular, basilic, cephalic, brachial etc.) have become an important alternative to catheterization from central veins. Usg-guided central venous catheterization has significant advantages compared to classical technique such as low perioperative complication rates and shorter procedure time. In this study, we aimed to compare three central catheterization methods performed by ultrasonography-guided internal jugular vein, subclavian vein and peripheral (cephalic) veins in pediatric patients in terms of procedure duration, major complications and success rates. Materials and Methods: After obtaining written informed consent from the patient's relatives, in our anesthesiology clinic, a total of 105 patients, 35 for each group, were enrolled from pediatric patients under the age of seven who had an indication for a central venous catheter. The patients were classified as internal jugular vein catheterization group (Group J), subclavian vein catheterization group (Group S), and peripheral (cephalic) central venous catheterization group (Group P). Demographic characteristics, catheterization characteristics (indication of catheterization, time of catheterization, success and efficacy) and complications during catheter insertion were recorded. Results: Demographic data were similar among the three groups. The mean catheterization time in Group J was 275.23 sec; Group S in 276.97 sec; Group P is 147.81 sec. The duration of catheterization in Group P was significantly lower than Group J and Group S. There was no statistically significant difference between Group J and Group S in terms of catheterization time. Discussion and Conclusion: USG guided central catheterization through peripheral veins in pediatric cases; We believe that it can be recommended as an alternative approach for internal jugular and subclavian vein catheterization because of shorter application time and less complication rate.