Significance of ultrasound navigation during central venous catheterization in children with scoliotic spinal deformity: a prospective observational single-centre study
- Authors: Smirnov I.V.1, Tsypin L.E.2, Lazarev V.V.2, Batyrova Z.K.3, Strunin O.V.1
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Affiliations:
- JSC «Medicina»
- Pirogov Russian National Research Medical University
- Research Center for Obstetrics, Gynecology and Perinatology
- Issue: Vol 16, No 3 (2022)
- Pages: 241-249
- Section: Original study articles
- URL: https://rjraap.com/1993-6508/article/view/108305
- DOI: https://doi.org/10.17816/RA108305
- ID: 108305
Cite item
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
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, MoscowLeonid 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, MoscowVladimir 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, MoscowZalina 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, MoscowOleg 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, MoscowReferences
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