Ultrasound Guided Technique for Internal Jugular Central Venous Catheterization in Pediatric Cardiac Surgical Patients

Study Overview
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Brief Summary
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The purpose of the study is to evaluate the success rate using ultrasound as guidance during central venous cannulation in pediatric cardiac surgical patients.

Detailed Description
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Central venous access may be essential in pediatric patients for fluid and a blood product administration, medication, parenteral nutrition, renal replacement therapy and hemodynamic monitoring. Obtaining central venous access in pediatric patients can be challenging, failure rates in pediatric patients range from 5% to 19% with reported complication rates from 2.5% to 22%. The landmark technique has been standard approach for many years. In comparison with landmark method, in pediatric patients, the use of ultrasound is associated with an increased success rate decreased operative time, reduced number of cannulation attempts , and a decreased number of carotid artery punctures. This study is designed to evaluate the success rate, complications, time taken for successful cannulation and their correlation with cross sectional area of the vein.

Official Title
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Ultrasound Guided Technique for Internal Jugular Central Venous Catheterization in Pediatric Cardiac Surgical Patients

Conditions
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Accidental Puncture of Artery During Catheter Insertion

Intervention / Treatment
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* Device: Central Venous Catheterization


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients requiring central venous catheterization for elective cardiac surgery. Age below 15 years. Exclusion Criteria: Patient's guardian's refusal Bleeding disorders Clotting abnormalities (platelets count < 75,000/cumm, INR > 2) Local site of infection Underlying pneumothorax, pleural effusion or preoperative insertion of chest tube

Ages Eligible for Study
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Minimum Age: 1 Day
Maximum Age: 15 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Supportive Care
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Other: Pediatric Cardiac Surgical Patients<br>Central Venous Catheterization | Device: Central Venous Catheterization<br>* Ultrasound guided internal jugular venous catheterization<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of Attempts for Successful Central Venous Cannulation | An attempt will be considered when complete withdrawal of the puncturing needle out of skin surface will occur | up to 24 hours after intervention | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Time to Successful Cannulation | Time from skin prick to blood aspiration via the catheter immediately following the guide-wire removal | up to 1 hour after intervention | 
| Number of Patients With Complications | Arterial puncture, Hemothorax, Pneumothorax, Local site hematoma | up to 24 hours after intervention |