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Computer-assisted needle navigation for pediatric internal jugular central venous cannulation: A feasibility study.

ABSTRACT: INTRODUCTION:Vascular access for central venous catheter placement is technically challenging in children. Ultrasound guidance is recommended for pediatric central venous catheter placement, yet many practitioners rely on imprecise anatomic landmark techniques risking procedure failure due to difficulty mastering ultrasound guidance. A novel navigation system provides a visual overlay on real-time ultrasound images to depict needle trajectory and tip location during cannulation. We report the first pediatric study assessing feasibility and preliminary safety of using a computer-assisted needle navigation system to aid in central venous access. METHODS:A prospective, institutional review board-approved feasibility study was performed. All participants provided written informed consent. Ten patients (mean age: 11.4?years, five males) underwent central venous catheter placement with ultrasound and navigation system guidance. All procedures were performed by interventional radiologists expert in vascular access. Feasibility was measured through binary (yes/no) responses from participating users assessing device usability and feasibility. The number of needle passes and procedure time measures were also recorded. RESULTS:Internal jugular veins (seven right sided, three left sided) were cannulated in all patients with no complications. Users confirmed navigation system feasibility in all 10 participants. Mean vein diameter and depth was 13.3?×?9.8?±?3.4?×?2.1 and 7.0?±?1.7?mm, respectively. Successful cannulation occurred in all patients and required only a single needle pass in 9 of 10 patients. Mean device set-up and vascular access times were 5:31?±?2:28 and 1:48?±?2:35?min, respectively. CONCLUSION:This pilot study suggests that it is feasible to use a novel computer-assisted needle navigation system to safely obtain central venous access under ultrasound guidance in pediatric patients.

SUBMITTER: Gallo C

PROVIDER: S-EPMC7606770 | biostudies-literature | 2020 Nov

REPOSITORIES: biostudies-literature

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Computer-assisted needle navigation for pediatric internal jugular central venous cannulation: A feasibility study.

Gallo Christopher C Foroughi Pezhman P Meagher Elisabeth E Vellody Ranjith R Yadav Bhupender B Ho Anthony A Demir Alican A Heisenberg Dorothee D Cleary Kevin K Sharma Karun K

The journal of vascular access 20200427 6

<h4>Introduction</h4>Vascular access for central venous catheter placement is technically challenging in children. Ultrasound guidance is recommended for pediatric central venous catheter placement, yet many practitioners rely on imprecise anatomic landmark techniques risking procedure failure due to difficulty mastering ultrasound guidance. A novel navigation system provides a visual overlay on real-time ultrasound images to depict needle trajectory and tip location during cannulation. We repor ...[more]

PMID: 32339064

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Project description:OBJECTIVES:To assess the evidence for the clinical effectiveness of ultrasound guided central venous cannulation. DATA SOURCES:15 electronic bibliographic databases, covering biomedical, science, social science, health economics, and grey literature. DESIGN:Systematic review and meta-analysis of randomised controlled trials. Populations Patients scheduled for central venous access. INTERVENTION REVIEWED: Guidance using real time two dimensional ultrasonography or Doppler needles and probes compared with the anatomical landmark method of cannulation. DATA EXTRACTION:Risk of failed catheter placement (primary outcome), risk of complications from placement, risk of failure on first attempt at placement, number of attempts to successful catheterisation, and time (seconds) to successful catheterisation. DATA SYNTHESIS:18 trials (1646 participants) were identified. Compared with the landmark method, real time two dimensional ultrasound guidance for cannulating the internal jugular vein in adults was associated with a significantly lower failure rate both overall (relative risk 0.14, 95% confidence interval 0.06 to 0.33) and on the first attempt (0.59, 0.39 to 0.88). Limited evidence favoured two dimensional ultrasound guidance for subclavian vein and femoral vein procedures in adults (0.14, 0.04 to 0.57 and 0.29, 0.07 to 1.21, respectively). Three studies in infants confirmed a higher success rate with two dimensional ultrasonography for internal jugular procedures (0.15, 0.03 to 0.64). Doppler guided cannulation of the internal jugular vein in adults was more successful than the landmark method (0.39, 0.17 to 0.92), but the landmark method was more successful for subclavian vein procedures (1.48, 1.03 to 2.14). No significant difference was found between these techniques for cannulation of the internal jugular vein in infants. An indirect comparison of relative risks suggested that two dimensional ultrasonography would be more successful than Doppler guidance for subclavian vein procedures in adults (0.09, 0.02 to 0.38). CONCLUSIONS:Evidence supports the use of two dimensional ultrasonography for central venous cannulation.

Dataset Information

Computer-assisted needle navigation for pediatric internal jugular central venous cannulation: A feasibility study.

Publications

Computer-assisted needle navigation for pediatric internal jugular central venous cannulation: A feasibility study.

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