Ultrasound-Guided Cannulation of the Brachiocephalic Vein in Neonates and Preterm Infants: A Prospective Observational Study

2017 ◽  
Vol 35 (05) ◽  
pp. 503-508 ◽  
Author(s):  
Paula Alonso-Quintela ◽  
Sandra Terroba-Seara ◽  
Aquilina Jiménez-González ◽  
Silvia Rodríguez-Blanco ◽  
José Vázquez-Martínez ◽  
...  
Keyword(s):  
Observational Study ◽  
Success Rate ◽  
Preterm Infants ◽  
Neonatal Intensive Care ◽  
Prospective Observational Study ◽  
Venous Catheter ◽  
Late Complications ◽  
Brachiocephalic Vein ◽  
Success Rates ◽  
Low Weight

Introduction Percutaneous central venous catheter (CVC) insertion is a challenging procedure in neonates, especially in preterm infants. Objective This study aims to describe the technical success and safety profile of ultrasound (US)-guided brachiocephalic vein (BCV) cannulation in neonates. Methods Prospective observational study. Neonates admitted to the neonatal intensive care unit (NICU) in whom US-guided cannulation of the BCV was attempted were eligible. Outcomes included first attempt success rate, the overall success rate, the number of attempts, the cannulation time, immediate mechanical complications, catheter indwelling days, and late complications. Results A total of 40 procedures in 37 patients were included. Median weight and age at the time of cannulation were 1.85 kg (0.76–4.8) and 13 days (3–31), respectively. First attempt and overall success rates were 29 (72.5%) and 38 (95%), respectively. No major complications were observed. Catheter-associated infection rate was 2.4/1,000 catheter days. There were no difference in outcomes between low weight preterm infants (<1.5 kg) and the rest of the cohort. There was no linear relationship between weight at time of insertion and the number of puncture attempts (r = 0.250; p = 0.154) or cannulation time (r = 0.257; p = 0.142). Conclusion US-guided cannulation of the BCV may be considered in acutely ill neonates, including small preterm infants, who need a large bore CVC.

scholarly journals Single-centre prospective observational study on postdelivery room care

2020 ◽  
Vol 4 (1) ◽  
pp. e000602
Author(s):  
Frederike Vivien Hartmann ◽  
Gerd Bauerschmitz ◽  
Helmut Küster
Keyword(s):  
Birth Weight ◽  
Observational Study ◽  
Preterm Infants ◽  
Neonatal Intensive Care ◽  
Prospective Observational Study ◽  
Total Duration ◽  
Extremely Low Birth Weight ◽  
Single Centre ◽  
Term Outcome ◽  
Long Term Outcome

ObjectivesAs quality of care in the delivery room has major impact on outcome of preterm infants, multiple guidelines have been established in recent years. There is, however, little evidence on how to proceed during postdelivery room care, the time of transfer and admission to the neonatal intensive care unit (NICU). The aim of this study was to identify processes taking place during this period with potential impact on outcome.Study designProspective observational study.SettingSingle-centre German tertiary NICU.Patients40 inborn preterm infants undergoing postdelivery room care.Main outcomePrevalence of prolonged duration of postdelivery room care, disconnections from the ventilator and positioning of preterm infants.ResultsTotal duration of postdelivery room care and NICU admission procedures were shorter in infants transferred in a transport incubator compared with using a NICU care station from birth. Extremely low birth weight (ELBW) infants spend 8% of the time in prone position in contrast to 39% in non-ELBW. Total duration of disconnection from the ventilator was 50 s and was ten times longer in infants who had nasal CPAP compared with infants intratracheally intubated. Infants with nCPAP had longer duration of disconnection from the ventilator if body weight was >1000 g or if they were transferred in a transport incubator.ConclusionsMultiple parameters like birth weight or type of transport affect neonatal care during the postdelivery room period. Prospective studies are needed to identify and optimise parameters within this period that affect long-term outcome.

scholarly journals Learning Curve for the Acquisition of 20 Standard Two-Dimensional Images in Advanced Perioperative Transesophageal Echocardiography: A Prospective Observational Study

2021 ◽  
Author(s):  
Prasert Sawasdiwipachai ◽  
Sasithorn Thanasriphakdeekul ◽  
Vithaya Chithiraphan ◽  
Kasana Raksamani ◽  
Kamheang Vacharaksa
Keyword(s):  
Observational Study ◽  
Learning Curve ◽  
Transesophageal Echocardiography ◽  
Success Rate ◽  
Prospective Observational Study ◽  
Two Dimensional ◽  
Trainee Group ◽  
Short Course ◽  
Thoracic Anesthesia ◽  
Intraoperative Transesophageal Echocardiography

Abstract Background Learning to perform intraoperative transesophageal echocardiography takes time and practice. We aimed to determine the cumulative success rate in the first 20 intraoperative transesophageal echocardiography cases performed by trainee anesthesiologists with no transesophageal echocardiography experience. Methods This prospective observational study included nine anesthesiologists (four cardiovascular and thoracic anesthesia fellows and five short-course perioperative intraoperative transesophageal echocardiography trainees). Overall, 180 studies self-performed by the trainees were reviewed by certified reviewers. A study was considered successful when at least 15 qualified images were collected within 30 minutes. The cumulative success of each trainee was used as a surrogate of a basic two-dimensional intraoperative transesophageal echocardiography learning curve. Results The participants comprised three male and six female anesthesiologists aged 29–43 years with 2–13 years of work experience. Most studies (146/180, 81.11%) were completed within 30 minutes, and the cumulative success rate was 70–90% (average 82.78 ± 6.71%). The average cumulative success rate in the short-course group (85 ± 7.07%) was higher than that in the official cardiovascular and thoracic fellow trainee group (80 ± 7.07%). The recommended caseload for a 75–80% success rate was 14–18 cases (95% confidence interval, 0.675–0.969). Conclusions We recommended a 14–18 caseload for a target success rate of 75–80% in studies performed by trainees with no previous experience. Our findings will enable the development of programs to train anesthesiologists in intraoperative transesophageal echocardiography.

DOZ047.91: Bronchoscopic treatment of recurrent tracheoesophageal fistula: is it an effective option?

2019 ◽  
Vol 32 (Supplement_1) ◽  
Author(s):  
N Valiyev ◽  
K K Cerit ◽  
M Y Erdas ◽  
A P Ergenekon ◽  
G Kiyan
Keyword(s):  
Success Rate ◽  
Tracheoesophageal Fistula ◽  
Late Complications ◽  
Laser Coagulation ◽  
Success Rates ◽  
Surgical Closure ◽  
Endoscopic Method ◽  
Effective Option ◽  
Age Range

Abstract Purpose Despite technical and surgical improvements, treatment of recurrent tracheoesophageal fistula (rTEF) still remains a challenging problem in pediatric patients. Bronchoscopic closure of rTEF using different agents is described with different success rates in the literature. This study aimed to report results of patients with rTEF treated with chemocauterization using trichloroacetic acid (TCA) and with laser cauterization (LC) followed by fibrin glue (FG) application. Methods Nine patients with rTEF were included in the study from 2014 to 2018. Four patients underwent fistula closure with LC followed by FG application, while another four patients had chemocauterization with TCA. In one case both agents were used. Patients were checked for the success of the treatment by bronchoscopy. All patients had the diagnosis of rTEF. Seven patients had EA with distal TEF and the remaining two patients had H-type TEF as primary pathologies. FG application was performed by LC followed by injection of FG into the fistula. Application of the TCA was made by a TCA-soaked sponge for 30 seconds and 3 times each trial. Results Nine children of the age range 4 months to 5 years (mean 1.5 year) were treated endoscopically. Follow-up ranged between 3 months and 5 years (mean 28 months). Among the nine patients only in one patient with only laser coagulation with FG application the treatment was successful. In the remaining eight patients all attempts failed. All these patients underwent open surgical closure of the fistula. There were no acute or late complications related to either endoscopic method. Conclusion The results of this study suggest that endoscopic occlusion of recurrent TEF has a low success rate. Surgical closure is still a standard method with a high success rate. Even though endoscopic options are less invasive, they prolong the period of aspiration and may cause increased pulmonary problems.

scholarly journals 136 Effect of fentanyl boluses on cerebral oxygenation and hemodynamics in preterm infants: A prospective observational study

2019 ◽  
Vol 24 (Supplement_2) ◽  
pp. e53-e54
Author(s):  
Souvik Mitra ◽  
Ege Babadagli ◽  
Helen McCord ◽  
Averie DePalma ◽  
Walid El-Naggar ◽  
...  
Keyword(s):  
Observational Study ◽  
Preterm Infants ◽  
Prospective Observational Study ◽  
Cerebral Oxygenation

scholarly journals Evaluation of transmitted glow point at a priori chosen depth (1 cm below vocal cords) for lightwand intubation: a prospective observational study

2020 ◽  
Vol 48 (12) ◽  
pp. 030006052097424
Author(s):  
Eunyoung Cho ◽  
Hyun-Chang Kim ◽  
Jung-Man Lee ◽  
Ji-Hoon Park ◽  
Najeong Ha ◽  
...  
Keyword(s):  
Observational Study ◽  
Confidence Interval ◽  
Success Rate ◽  
Prospective Observational Study ◽  
Cricoid Cartilage ◽  
A Priori ◽  
Thyroid Cartilage ◽  
Suprasternal Notch ◽  
Vocal Cords ◽  
Laryngeal Injury

Objective When performing lightwand intubation, an improper transmitted glow position before tube advancement can cause intubation failure or laryngeal injury. This study was performed to explore the transmitted glow point corresponding to a priori chosen depth for lightwand intubation. Methods Before lightwand intubation, we marked the transmitted glow point from a bronchoscope on the neck when it reached 1 cm below the vocal cords. Lightwand intubation was then performed using this marking point. The distances from the mark to the upper border of the thyroid cartilage, upper border of the cricoid cartilage, and suprasternal notch were measured. Results In total, 107 patients were enrolled. The success rate of lightwand intubation using the mark was 93.5% (95% confidence interval, 88.7%–99.2%) at the first attempt. The marking point was placed 12.0 mm (95% confidence interval, 10.6–13.4 mm) below the upper border of the cricoid cartilage. Conclusion Anaesthesiologists should be aware of the appropriate point of the transmitted glow on the patient’s neck when performing lightwand intubation. We suggest that this point is approximately 1 cm below the upper border of the cricoid cartilage. Trial registration: ClinicalTrials.gov NCT03480035

Sign in / Sign up

Export Citation Format

Share Document