Dynamic ultrasound‐guided short‐axis needle tip navigation technique vs. landmark technique for difficult saphenous vein access in children: a randomised study

摘要

Summary Dynamic ultrasound‐guided short‐axis needle tip navigation is a novel technique for vascular access. After venipuncture, the needle and catheter are further advanced within the vessel lumen under real‐time ultrasound guidance with constant visualisation of the needle tip in the short‐axis view. This can minimise the risk of transfixing the cannulated vessel. We compared two techniques for non‐visible saphenous vein cannulation under general anaesthesia in children weighing ≥?3?kg and less than four?years of age: dynamic ultrasound‐guided short‐axis needle tip navigation technique (ultrasound group) vs. landmark technique. Venous cannulation was performed by three experienced anaesthetists. The primary outcome measure was first‐attempt success rate. Success rate within 10?min was a secondary outcome. A total of 102 patients were randomly allocated to either the ultrasound group or the landmark group. First‐attempt success rate was 90% in the ultrasound group compared with 51% in the landmark group, p0.001, difference 39%, 95% confidence interval ( CI ) of the difference 23–55%. Success rate within 10?min was 92% in the ultrasound group compared with 63% in the landmark group, p?=?0.001, difference 29%, 95%CI of the difference 14–45%. We conclude that, when performed by experienced anaesthetists, the dynamic ultrasound‐guided short‐axis needle tip navigation technique improved non‐visible saphenous vein cannulation in children compared with the landmark technique.