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Corresponding Author

 Awwad Mohamed Awwad Hassan

Document Type

Original Article

Abstract

Background: Vascular access is frequently required in neonates. Although SCV cannulation has the benefit of established landmarks, it is possible to have potentially serious consequences, such as pneumothorax and hemothorax.

Aim: This study aims to compare the success rate and complications of the landmark technique to an ultrasound-guided technique for subclavian vein catheterization in neonates.

Methods: This is a prospective randomized controlled study conducted on 100 neonates equally allocated to receive either landmark- or Ultrasound-guided subclavian vein catheterization. All patients were assessed using the procedure parameters, which included procedure duration, cannulation site, number of attempts, and success rate. Procedural complications such as pneumothorax, hematoma and malposition were also measured, and comparisons between the groups were conducted.

Results: The ultrasound technique was more time-consuming, with a mean of 9.3 minutes, ranging from 7 to 12 minutes, with a significant comparison with the landmark guide, with a mean of 2.5 minutes ranging from 2 to 4 minutes. The first-placement success rate was significantly more prevalent in the ultrasound group compared to the landmark group (86% vs. 42 %, p<0.001). This study reported a statistically significant difference between the two groups regarding the need for mechanical ventilation cessation during the procedure (p <0.001). The overall complication rate was significantly higher in B compared to group A (14%vs 10%, p <0.001).

Conclusion: This study concluded that with a low incidence of complications and similar success rate, subclavian vein cannulation with landmark-guided method showed comparable safety and efficacy to the US-guided method in neonates. The landmark-guided technique is less time-consuming than the ultrasound-guided technique. It is recommended in emergency circumstances to utilize the landmark technique of subclavian vein cannulation.

Keywords

Subclavian vein; Neonates; Ultrasound, Landmark

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