Lung Deflation in Pediatric Subclavian Vein Catheterization

Study Overview
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Brief Summary
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The subclavian vein (SCV) is a preferred site for placement of central venous catheter. However, pneumothorax is a major concern during subclavian venous catheterization. Lung deflation, by decreasing lung volume, may reduce the risk of pneumothorax by increasing the distance between the pleura and the SCV. The investigators evaluated the effect of lung deflation on the relative position between the pleura and the line of the imaginary needle pathway during supraclavicular and infraclavicular approach to the subclavian vein (SCV) using ultrasonography.

Official Title
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The Effect of Lung Deflation on the Position of the Pleura in Mechanically Ventilated Infants During Subclavian Vein Cannulation: an Ultrasound Study

Conditions
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Pediatric Subclavian Vein Catheterization

Intervention / Treatment
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* Procedure: lung deflation
* Procedure: lung inflation


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Pediatric patients who were scheduled for elective operation under general anesthesia Neonates (0   1 mo), Infants (1 mo   1 yr) Exclusion Criteria: Structural anomalies of the chest wall History of lung and chest wall operations Prior central venous catheterization Upper respiratory tract infection, or pneumonia within 2 weeks

Ages Eligible for Study
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Maximum Age: 1 Year

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: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: respiration cycle<br>lung inflation and deflation | Procedure: lung deflation<br>* lung was deflated during respiration cycle<br>Procedure: lung inflation<br>* lung was inflated during respiratory cycle<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| The distance between the pleura and the line of the imaginary needle pathway (DPI) | The ultra-sonography probe was adjusted to obtain an image containing the long-axis cross section of SCV, the pleura, the clavicle, and the first rib. Images were recorded by the same physician during whole respiratory cycle with the probe held in the identical position. Imaginary lines for supraclavicular and infraclavicular approach were drawn, and distances from the pleura were measured. If the pleura touched the INP, the distance was recorded as positive value. If the pleura did not touch the INP, the distance was recorded as negative value. | Within 5 minutes | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| The incidence of pleural movement over the imaginary needle pathway | If the pleura touched the imaginary needle pathway, the incidence was checked. | Within 5 minutes | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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subclavian vein, ultrasound, distance between the subclavian vein and the lung