Significance of ultrasound navigation during central venous catheterization in children with scoliotic spinal deformity: a prospective observational single-centre study

Cover Page


Cite item

Full Text

Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription or Fee Access

Abstract

BACKGROUND: Surgeries to correct scoliotic spinal deformity (posterior corrective transpediculocorporal fusion) are classified as highly traumatic, are accompanied by significant blood loss, and require reliable venous access. Central vein catheterization is an important part of patient management and is a successful and safe procedure.

AIM: To evaluate the effectiveness of ultrasound navigation during central venous catheterization in patients with severe and super-severe scoliotic spinal deformity.

MATERIALS AND METHODS: A single-center prospective study included 52 patients aged 6 to 18 (median age 13.2) years undergoing surgical treatment to correct grade IV scoliotic spinal deformity. Patients underwent catheterization of the internal jugular vein under ultrasound navigation using an ultrasound scanner with a linear sensor and a frequency of 7–13 MHz. The procedures were performed by one operator. The following were assessed: anatomy of the neurovascular bundle, relative position of the vessels relative to each other, size of the internal jugular vein in a horizontal and Trendelenburg positions, frequency and time of the procedure, and complications during puncture and catheterization.

RESULTS: In patients with severe scoliotic deformity of the spine, an atypical location of neck vessels was noted in every fifth patient (13.46%). The peculiarity of the location of the vessels was associated with congenital developmental anomalies. The most common anomaly in the location of the vessels relative to each other was the medial location of the internal jugular vein relative to the carotid artery. In one patient, the passage of the internal jugular vein at a considerable distance from the carotid artery was revealed, which made it impossible to puncture according to anatomical landmarks. The average diameter of the internal jugular vein in the horizontal position was 6.2±0.9 mm. In the Trendelenburg position, the diameter was 9.08±1.5 mm. The average duration of the procedure was 92 seconds (±70). Taking into account the use of ultrasound navigation during catheterization of the internal jugular vein, no early and late complications occurred.

CONCLUSION: The use of ultrasound navigation for central venous catheterization during surgical treatment of severe and super-severe scoliotic deformities of the spine is a safe and essential method. The Trendelenburg position allows for better visualization of the jugular vein and facilitates its puncture and catheterization. The use of ultrasonography during invasive vascular manipulations allows for minimizing the number of failed catheterizations and avoiding complications, which improves the efficiency of medical care and increases the level of comfort and safety for the patient.

Full Text

Restricted Access

About the authors

Igor V. Smirnov

JSC «Medicina»

Author for correspondence.
Email: smirnov@medicina.ru
ORCID iD: 0000-0002-5348-3400
SPIN-code: 2224-3530

anesthesiologist-resuscitator, head of intensive care

Russian Federation, Moscow

Leonid E. Tsypin

Pirogov Russian National Research Medical University

Email: 79951131285@list.ru
ORCID iD: 0000-0002-3114-8759
SPIN-code: 5062-2010

MD, Dr. Sci. (Med.), Professor

Russian Federation, Moscow

Vladimir V. Lazarev

Pirogov Russian National Research Medical University

Email: 79951131285@list.ru
ORCID iD: 0000-0001-8417-3555
SPIN-code: 4414-0677

MD, Dr. Sci. (Med.), Professor

Russian Federation, Moscow

Zalina K. Batyrova

Research Center for Obstetrics, Gynecology and Perinatology

Email: 79951131285@list.ru
ORCID iD: 0000-0003-4997-6090
SPIN-code: 7226-1949

MD, Cand. Sci. (Med.), senior researcher

Russian Federation, Moscow

Oleg V. Strunin

JSC «Medicina»

Email: strunin.o@medicina.ru
ORCID iD: 0000-0003-2537-954X
SPIN-code: 4734-0837

MD, Dr. Sci. (Med.), anesthesiologist-resuscitator

Russian Federation, Moscow

References

  1. Riabykh SO, Savin DM, Medvedeva SN, et al. The experience in treatment of the spine neurogenic deformities. Genij Ortopedii. 2013;(1):87–92. (In Russ)
  2. Sadovaya TN, Tsytsorina IA. Screening of spinal deformations in children as component of public health protection. Politravma. 2011;(3):2328. (In Russ)
  3. Di Silvestre M, Zanirato A, Greggi T, et al. Severe adolescent idiopathic scoliosis: posterior staged correction using a temporary magnetically-controlled growing rod. Eur Spine J. 2020;29(8): 2046-2053. doi: 10.1007/s00586-020-06483-8
  4. Garcia-Leal M, Guzman-Lopez S, Verdines-Perez AM, et al. Trendelenburg position for internal jugular vein catheterization: A systematic review and meta-analysis. J Vasc Access. 2021;112972982110313. doi: 10.1177/11297298211031339
  5. Alderson PJ, Burrows FA, Stemp LI, Holtby HM. Use of ultrasound to evaluate internal jugular vein anatomy and to facilitate central venous cannulation in paediatric patients. Br J Anaesth. 1993;70(2):145–148. doi: 10.1093/bja/70.2.145
  6. Zabolotskii DV, Ul’rikh GE, Malashenko NS, et al. Internal jugular vein catheterization in children with spinal deformities under ultrasound guidance. Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2011;3:98–101. (In Russ).
  7. Gordon AC, Saliken JC, Johns D, et al. US-guided Puncture of the Internal Jugular Vein: Complications and Anatomic Considerations. J Vasc Interv Radiol. 1998;9(2):333–338. doi: 10.1016/S1051-0443(98)70277-5
  8. McGee DC, Gould MK. Preventing Complications of Central Venous Catheterization. N Engl J Med. 2003;348(12):1123–1133. doi: 10.1056/nejmra011883
  9. Matveyeva EYu, Vlasenko AV, Yakovlev VN, Alekseyev VG. Infectious Complications of Central Venous Catheterization. General Reanimatology. 2011;7(5):67. (In Russ). doi: 10.15360/1813-9779-2011-5-67
  10. Sumin SA, Kuzkov VV, Gorbachev VI, Shapovalov KG. Catheterization of the subclavian and other central veins. Guidelines. Annals of Critical Care. 2020;1:7–18. (In Russ). doi: 10.21320/1818-474X-2020-1-7-18
  11. Rouzen M, Latto YaP, Ng U Sheng. Chreskozhnaya kateterizatsiya tsentral’nykh ven. Moscow: Meditsina; 1986. (In Russ).
  12. Moureau NL, Carr PJ. Vessel Health and Preservation: a model and clinical pathway for using vascular access devices. Br J Nurs. 2018;27(8):S28–S35. doi: 10.12968/bjon.2018.27.8.S28
  13. Hatfield A, Bodenham A. Portable ultrasound for difficult central venous access. Br J Anaesth. 1999;82(6):822–826. doi: 10.1093/bja/82.6.822
  14. Bykov MV, Lazarev VV, Bagaev VG, et al. Injure to the vagus nerve in the puncture and catheterization of the internal jugular vein. Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2017;7(3):54–62. (In Russ). doi: 10.17816/psaic334
  15. Schindler E, Mikus M, Velten M. Central Venous Access in Children: Technique and Complications. Anästhesiol Intensivmed Notfallmed Schmerzther. 2021;56(1):60–68. (In German). doi: 10.1055/a-1187-5397
  16. Naik VM, Mantha SSP, Rayani BK. Vascular access in children. Indian J Anaesth. 2019;63(9):737–745. doi: 10.4103/ija.IJA_489_19
  17. Petzoldt R, Lutz H, Ehler R, et al. Puncture of veins and arteries assisted by ultrasound. Ultrasound Med Biol. 1977;2(4):331–333. doi: 10.1016/0301-5629(77)90037-0
  18. Bruzoni M, Slater BJ, Wall J, et al. A Prospective Randomized Trial of Ultrasound — vs Landmark-Guided Central Venous Access in the Pediatric Population. J Am Coll Surg. 2013;216(5):939–943. doi: 10.1016/j.jamcollsurg.2013.01.054

Supplementary files

Supplementary Files
Action
1. Fig. 1. Ultrasound scanning of the carotid artery (A) and internal jugular vein (V). a — transverse scanning, b — longitudinal scanning.

Download (424KB)
2. Fig. 2. Ultrasound scanning of the vascular bundle of the neck shows a change in the blood supply to the internal jugular vein (V) relative to the carotid artery (A) in horizontal position (а) and in modified Trendelenburg position (b).

Download (395KB)
3. Fig. 3. Ultrasound scanning of the internal jugular vein at the time of catheterization. а — transverse scanning, b — longitudinal scanning (arrow shows location of catheter in the vessel lumen).

Download (427KB)

Copyright (c) 2023 Eco-Vector



СМИ зарегистрировано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор).
Регистрационный номер и дата принятия решения о регистрации СМИ: серия ПИ ФС 77 - 55827 от 30.10.2013 г
СМИ зарегистрировано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор).
Регистрационный номер и дата принятия решения о регистрации СМИ: серия ЭЛ № ЭЛ № ФС 77 - 80651 от 15.03.2021 г
.



This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies