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A Randomized Trial of Ultrasound- versus. Fluoroscopy-Guided Subclavian Vein Catheterization in Children with Hematologic Disease

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Abstract

Objective

To compare the ultrasound- and fluoroscopy-guided subclavian vein catheterization in pediatric population with hematologic diseases.

Methods

A randomized prospective study of subclavian vein catheterization in pediatric population with hematologic diseases was performed. After randomization, the patients were assigned to either ultrasound- or fluoroscopy-guided subclavian vein catheterization. The primary outcome was number of attempts at venous cannulation. Secondary outcomes included: catheterization success rate, fluoroscopy time, operation time, and surgical complications.

Results

There were 170 children enrolled between February 2017 and July 2018. There was no difference between the two groups with regard to the demographic data. Success within 3 attempts was achieved in 82 cases (82/87, 92.0%) in the ultrasound (US) group vs. 65 cases (65/83, 78.3%) in the fluoroscopy group (P = 0.002). The average operation time was 10(7) min in US group vs. 10(6) min in fluoroscopy group (P = 0.722). There were 3 complications in the US group, while there were 6 complications in the fluoroscopy group (P = 0.321). There were 4 catheter-related thrombosis (CRTs) found in the US group during follow-up, however there was no CRT in the fluoroscopy group (P = 0.121).

Conclusions

Ultrasound-guided venous puncture is a more accurate method of subclavian vein catheterization. However, the catheter tip can be placed more precisely by fluoroscopy. Thus, combined ultrasound-and fluoroscopy-guided technology is more efficient in subclavian vein catheterization of children with hematologic disease.

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Authors and Affiliations

  1. Department of Interventional Radiology, Nanfang Hospital, Southern Medical University, Guangzhou, China

    Huajin Pang, Yong Chen & Xiaofeng He

  2. Huazhong University of Science and Technology, Wuhan, China

    Xuehan Liu

  3. Department of Medical Ultrasound, Nanfang Hospital, Southern Medical University, Guangzhou, China

    Weizhen Wang & Zhi Liu

Authors
  1. Huajin Pang
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  2. Yong Chen
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  3. Xuehan Liu
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  4. Xiaofeng He
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  6. Zhi Liu
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Contributions

HP, YC: Study conception and design; HP, WW, ZL: Acquisition of data; XH, XL: Analysis and interpretation of data; HP: Drafting of manuscript and critical revision. HP is the guarantor for this paper.

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Correspondence to Huajin Pang.

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Pang, H., Chen, Y., Liu, X. et al. A Randomized Trial of Ultrasound- versus. Fluoroscopy-Guided Subclavian Vein Catheterization in Children with Hematologic Disease. Indian J Pediatr 86, 1021–1027 (2019). https://doi.org/10.1007/s12098-019-03021-3

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  • DOI: https://doi.org/10.1007/s12098-019-03021-3

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