Turkish Journal of Anaesthesiology & Reanimation

Ultrasound-Guided Cannulation of the Brachiocephalic Vein in Infants and Children is Useful and Stable


Department of Anesthesiology State University of New York at Buffalo, Buffalo NY, USA


Department of Anesthesiology Texas Tech University of Health Sciences, Lubbock TX, USA


Department of Anesthesiology Covenant Children’s Hospital, Lubbock TX, USA

Turk J Anaesthesiol Reanim 2017; 45: 153-157
DOI: 10.5152/TJAR.2017.67535
Read: 413 Downloads: 168 Published: 23 September 2019

Objective: Ultrasound-guided (USG) cannulation of the brachiocephalic vein (BCV) has been shown to be technically easy. We hypothesised that adoption of USG in-plane cannulation of the BCV as the primary approach to central venous cannulation at our institution would lead to central venous cannulation for a greater variety of indications.

Methods: We performed retrospective, descriptive comparison of all central lines placed in patients aged <16 years who underwent any surgical operation during calendar years 2012–2014 at a small, free-standing children’s hospital. The use and management of a central line was reviewed until the patient was discharged from the hospital. Analysis of the data was performed using simple comparative statistical methods.

Results: Forty-nine patients were identified, 20 who weighed <10 kg and 29 who weighed >10 kg. Cannulation was successful in all patients. No significant late complications occurred. Catheters were well tolerated post-operatively, with no accidental dislodgement and no removal because of discomfort. The average duration of insertion was 6.3 (3–20±3.77) days. Nine catheters were placed for access during emergency surgery. 15 were placed in patients with difficult peripheral intravenous (PIV) access. The central lines remained in place until discharge in 79.6% of patients. In 40% of patients, the PIV catheter was removed, and the central line was retained because of preference. Total parenteral nutrition (TPN) was administered in 11 (22.4%) patients.

Conclusion: Cannulation of BCV was well tolerated by children, with an average insertion duration of 6.3 days, which often lasted beyond the removal/failure of the PIV cannula. Catheters were useful for primary venous access during hospitalisation and for short TPN courses.

EISSN 2667-6370