Skip to main navigation menu Skip to main content Skip to site footer
##common.pageHeaderLogo.altText##

Original article

Vol. 154 No. 9 (2024)

Use of ultrasound for vascular access during cardiac catheterisation in children with congenital heart disease: a Swiss multicentre cohort study

DOI
https://doi.org/10.57187/s.3575
Cite this as:
Swiss Med Wkly. 2024;154:3575
Published
04.09.2024

Summary

AIM OF THE STUDY: Our study aimed to assess the first-attempt success rate of ultrasound (US) and anatomical landmark (ALM) guidance for vascular cannulation in children with congenital heart disease in Switzerland.

METHODS: A prospective observational multicentre study was conducted from January 2022 to January 2023 in three university hospitals in Switzerland. We included patients with congenital heart disease aged 0 to 18 years who were scheduled for elective cardiac catheterisation. Periprocedural data were collected anonymously. The choice of vessel and guidance technique were at the operator’s discretion.

RESULTS: 177 arterial and 240 venous cannulations in 253 patients were analysed. The median age and weight were 4.4 years (interquartile range [IQR] 1.2–8.8) and 15 kg (IQR 8–27), respectively. Nearly all operators, 97.5%, were deemed experienced. The femoral artery and femoral vein were the most preferred vessels. US guidance was used in 62% of procedures, predominantly within populations who were younger, smaller and of lower weight.The success rate at the first attempt was notably higher with US guidance for arterial cannulation (US: 80%, ALM: 37%, p <0.001) and venous cannulation (US: 78% vs ALM: 47%, p <0.001). Overall success rates for venous and arterial cannulation were comparable between ultrasound and anatomical landmark guidance. A total of 45 complications (10.5%) occurred, with immediate uncomplicated haematoma being the most frequent.

CONCLUSION: US guidance is preferred for the localisation and cannulation of vessels during cardiac catheterisation within paediatric cardiology departments in Switzerland. Given its high success rate for first-attempt cannulation, US warrants additional research to evaluate its potential in reducing complications.

References

  1. Celermajer DS, Robinson JT, Taylor JF. Vascular access in previously catheterised children and adolescents: a prospective study of 131 consecutive cases. Br Heart J. 1993 Dec;70(6):554–7. doi: https://doi.org/10.1136/hrt.70.6.554 DOI: https://doi.org/10.1136/hrt.70.6.554
  2. Marquis-Gravel G, Tremblay-Gravel M, Lévesque J, Généreux P, Schampaert E, Palisaitis D, et al. Ultrasound guidance versus anatomical landmark approach for femoral artery access in coronary angiography: A randomized controlled trial and a meta-analysis. J Interv Cardiol. 2018 Aug;31(4):496–503. doi: https://doi.org/10.1111/joic.12492 DOI: https://doi.org/10.1111/joic.12492
  3. Stone P, Campbell J, Thompson S, Walker J. A prospective, randomized study comparing ultrasound versus fluoroscopic guided femoral arterial access in noncardiac vascular patients. J Vasc Surg. 2020 Jul;72(1):259–67. doi: https://doi.org/10.1016/j.jvs.2019.09.051 DOI: https://doi.org/10.1016/j.jvs.2019.09.051
  4. Sandoval Y, Burke MN, Lobo AS, Lips DL, Seto AH, Chavez I, et al.; Contemporary Arterial Access in the Cardiac Catheterization Laboratory. Contemporary Arterial Access in the Cardiac Catheterization Laboratory. JACC Cardiovasc Interv. 2017 Nov;10(22):2233–41. doi: https://doi.org/10.1016/j.jcin.2017.08.058 DOI: https://doi.org/10.1016/j.jcin.2017.08.058
  5. de Souza TH, Brandão MB, Nadal JA, Nogueira RJ. Ultrasound Guidance for Pediatric Central Venous Catheterization: A Meta-analysis. Pediatrics. 2018 Nov;142(5):e20181719. doi: https://doi.org/10.1542/peds.2018-1719 DOI: https://doi.org/10.1542/peds.2018-1719
  6. Aouad-Maroun M, Raphael CK, Sayyid SK, Farah F, Akl EA. Ultrasound-guided arterial cannulation for paediatrics. Cochrane Database Syst Rev. 2016 Sep;9(9):CD011364. DOI: https://doi.org/10.1002/14651858.CD011364.pub2
  7. Aouad MT, Kanazi GE, Abdallah FW, Moukaddem FH, Turbay MJ, Obeid MY, et al. Femoral vein cannulation performed by residents: a comparison between ultrasound-guided and landmark technique in infants and children undergoing cardiac surgery. Anesth Analg. 2010 Sep;111(3):724–8. doi: https://doi.org/10.1213/ANE.0b013e3181e9c475 DOI: https://doi.org/10.1213/ANE.0b013e3181e9c475
  8. Eldabaa AA, Elgebaly AS, Elhafz AA, Bassuni AS. E.A., Elhafz AAA, Bassuni AS., Comparison of ultrasound- guided vs. anatomical landmark-guided cannulation of the femoral vein at the optimum position in infant. S Afr J Anaesthesiol Analg. 2012;18(3):162–6. doi: https://doi.org/10.1080/22201173.2012.10872846 DOI: https://doi.org/10.1080/22201173.2012.10872846
  9. Siddik-Sayyid SM, Aouad MT, Ibrahim MH, Taha SK, Nawfal MF, Tfaili YJ, et al. Femoral arterial cannulation performed by residents: a comparison between ultrasound-guided and palpation technique in infants and children undergoing cardiac surgery. Paediatr Anaesth. 2016 Aug;26(8):823–30. doi: https://doi.org/10.1111/pan.12935 DOI: https://doi.org/10.1111/pan.12935
  10. Salık F, Bıçak M. Comparison of ultrasound-guided femoral artery cannulation versus palpation technique in neonates undergoing cardiac surgery. J Vasc Access. 2023 Jan;24(1):27–34. doi: https://doi.org/10.1177/11297298211023307 DOI: https://doi.org/10.1177/11297298211023307
  11. College’s Committee on Perioperative Care. Statement on recommendations for uniform use of real-time ultrasound guidance for placement of central venous catheters. Bull Am Coll Surg. 2008 Sep;93(9):35–6.
  12. Olsen TC, Rimstad IJ, Tarpgaard M, Holmberg S, Hallas P. Current use of ultrasound for central vascular access in children and infants in the Nordic countries—a cross-sectional study. J Vasc Access. 2015;16(2):148–51. doi: https://doi.org/10.5301/jva.5000326 DOI: https://doi.org/10.5301/jva.5000326
  13. López-Álvarez JM, Pérez-Quevedo O, Naya-Esteban J, Ramirez-Lorenzo T, Falcón-González JC, Lorenzo-Villegas DL. Ultrasound-guided pediatric vascular cannulation by inexperienced operators: outcomes in a training model. J Ultrasound. 2022 Jun;25(2):199–205. doi: https://doi.org/10.1007/s40477-021-00585-9 DOI: https://doi.org/10.1007/s40477-021-00585-9
  14. Bosman M, Kavanagh RJ. Two dimensional ultrasound guidance in central venous catheter placement; a postal survey of the practice and opinions of consultant pediatric anesthetists in the United Kingdom. Paediatr Anaesth. 2006 May;16(5):530–7. doi: https://doi.org/10.1111/j.1460-9592.2005.01822.x DOI: https://doi.org/10.1111/j.1460-9592.2005.01822.x

Most read articles by the same author(s)