Acesso Venoso Central no período neonatal na Era da ultrassonografia
Keywords:
Central Venous Catheters, Neonatology, Ultrasound, Neonatal Intensive Care UnitsAbstract
Introduction: Central venous access is widely used in critically ill patients. In neonatology, there is a technical difficulty related to the child's size and the possibility of performing access by puncture. With the advent of the ultrasound device, there was an improvement in venous access techniques, increasing the safety and reducing complications.
Method: retrospective study to evaluate the feasibility of ultrasound-guided central venous access in a neonatal intensive care unit from January 2022 to April 2023. Variables were weight, age, puncture attempts, puncture sites, complications, and catheter retention time.
Results: Thirty-three central venous catheter insertion procedures were analyzed, 15 in females and 18 in males. Ultrasonography was used in 81.8% of punctures, 12.1% of central venous punctures were performed without ultrasound, and 6.1% of venous access was by dissection. The central venous catheter implantation sites were: brachiocephalic vein in 24.2 %, jugular vein in 36.4%, and subclavian vein via infraclavicular route in 27.3%. No early complications (within 24 hours) were reported in any of the cases. The reason for device removal was elective in 45.5%, catheter obstruction in 15,2%, death in 9,1%, patient transfer to another service in 6,1%, confirmed catheter infection in 6,1%, suspected catheter infection in 6,1% and removed due to the catheter's indwelling time 3%.
Conclusion: Central venous access by puncture is viable in the neonatal period with few complications, and ultrasound-guided puncture has increased the alternatives for venous access and the safety of the procedure.
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