Central Venous Catheter Placement Using the Seldinger Technique

2021 ◽  
pp. 55-64
Author(s):  
Kirk Lalwani ◽  
Philip W. Yun
Keyword(s):  
Central Venous Catheter ◽  
Central Venous Access ◽  
Venous Catheter ◽  
Venous Access ◽  
Catheter Placement ◽  
Seldinger Technique ◽  
Central Venous ◽  
Rapid Infusion ◽  
Patient Factors ◽  
Central Venous Catheter Placement

Chapter 6 covers central venous catheter placement, which is often performed for major procedures or in critical pediatric patients. Indications include hemodynamic monitoring, administration of hyperosmolar medications, hemodialysis, and rapid infusion of fluids. Internal jugular, subclavian, and femoral veins are commonly used for central venous access. In the pediatric patient, factors that influence the site of placement include age, likely duration of use, operator expertise, and the need for sedation. After the site of placement is determined, optimal positioning of the patient and meticulous technique are paramount to increase the chance for success. The Seldinger technique is the preferred method for catheterizing the vein following needle venipuncture and is outlined step-by-step in this chapter.

scholarly journals Computer-assisted needle navigation for pediatric internal jugular central venous cannulation: A feasibility study

2020 ◽  
Vol 21 (6) ◽  
pp. 931-937
Author(s):  
Christopher Gallo ◽  
Pezhman Foroughi ◽  
Elisabeth Meagher ◽  
Ranjith Vellody ◽  
Bhupender Yadav ◽  
...  
Keyword(s):  
Central Venous Catheter ◽  
Vascular Access ◽  
Navigation System ◽  
Ultrasound Guidance ◽  
Central Venous Access ◽  
Venous Catheter ◽  
Catheter Placement ◽  
Computer Assisted ◽  
Central Venous ◽  
Central Venous Catheter Placement

Introduction: Vascular access for central venous catheter placement is technically challenging in children. Ultrasound guidance is recommended for pediatric central venous catheter placement, yet many practitioners rely on imprecise anatomic landmark techniques risking procedure failure due to difficulty mastering ultrasound guidance. A novel navigation system provides a visual overlay on real-time ultrasound images to depict needle trajectory and tip location during cannulation. We report the first pediatric study assessing feasibility and preliminary safety of using a computer-assisted needle navigation system to aid in central venous access. Methods: A prospective, institutional review board–approved feasibility study was performed. All participants provided written informed consent. Ten patients (mean age: 11.4 years, five males) underwent central venous catheter placement with ultrasound and navigation system guidance. All procedures were performed by interventional radiologists expert in vascular access. Feasibility was measured through binary (yes/no) responses from participating users assessing device usability and feasibility. The number of needle passes and procedure time measures were also recorded. Results: Internal jugular veins (seven right sided, three left sided) were cannulated in all patients with no complications. Users confirmed navigation system feasibility in all 10 participants. Mean vein diameter and depth was 13.3 × 9.8 ± 3.4 × 2.1 and 7.0 ± 1.7 mm, respectively. Successful cannulation occurred in all patients and required only a single needle pass in 9 of 10 patients. Mean device set-up and vascular access times were 5:31 ± 2:28 and 1:48 ± 2:35 min, respectively. Conclusion: This pilot study suggests that it is feasible to use a novel computer-assisted needle navigation system to safely obtain central venous access under ultrasound guidance in pediatric patients.

Hybrid angioplasty-catheter placement procedure performed in a hemodialysis patient with central venous obstruction disease. Presentation of a case

2020 ◽  
pp. 112972982098318
Author(s):  
Nikolaos Ptohis ◽  
Panagiotis G Theodoridis ◽  
Ioannis Raftopoulos
Keyword(s):  
Therapeutic Option ◽  
Central Venous Access ◽  
Major Complication ◽  
Venous Catheter ◽  
Venous Access ◽  
Transluminal Angioplasty ◽  
Catheter Placement ◽  
Venous Disease ◽  
Central Venous ◽  
Brachiocephalic Trunk

Obstruction or occlusion of the central veins (Central venous disease, CVD) represents a major complication in hemodialysis patients (HD) limiting central venous access available for a central venous catheter placement. Endovascular treatment with percutaneous transluminal angioplasty (PTA) is the first therapeutic option to restore patency and gain access. This case presents our initial experience of a HD patient with CVD treated with a combination therapy of a balloon PTA to the left brachiocephalic trunk, through the right hepatic vein and standard catheter placement technique to the previously occluded junction of the left internal jugular vein to the left subclavian vein.

scholarly journals Central Venous Catheter induced Atrial Fibrillation-A Case Report

2021 ◽  
Vol 39 (3) ◽  
pp. 200-204
Author(s):  
Masud Ahmed ◽  
Azizun Nessa ◽  
Md Al Amin Salek
Keyword(s):  
Atrial Fibrillation ◽  
Central Venous Catheter ◽  
Central Venous Access ◽  
Venous Catheter ◽  
Venous Access ◽  
Cardiac Complications ◽  
Haemodynamic Instability ◽  
Central Venous ◽  
Common Procedure ◽  
Dc Cardioversion

Though a common procedure, central venous access is related to morbidity and mortality of patients. Common cardiac complications caused by central venous catheters include premature atrial and ventricular contractions. But development of atrial fibrillation with haemodynamic instability is quite rare. We are reporting a patient who developed atrial fibrillation with hypotension while inserting central venous catheter through right subclavian vein by landmark technique. Patient was managed with DC cardioversion. Careful insertion of central venous catheter & prompt management of its complication is crucial to avoid catastrophe. J Bangladesh Coll Phys Surg 2021; 39(3): 200-204

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