Effectiveness and Safety of the Ultrasound Guidance for Internal Jugular Vein Catheterization in Pediatric Patients: A Meta-analysis_Chinese Journal of Evidence-Based Medicine

Authors：

 CHIDong-mei , YUHong , LanHai-dan ,  LIUBin

Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu 610041, China;

Corresponding author：

LIUBin, Email: liubinhx@foxmail.com

Keywords：

Ultrasonography; Internal jugular vein catheterization; Pediatrics; Systematic review; Meta-analysis; Randomized controlled trial

DOI：

10.7507/1672-2531.20160219

Video：

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Objective To systematically evaluate the efficacy and safety of anatomical landmark method (ALM) versus ultrasound (US)-guided internal jugular vein (IJV) catheterization in pediatric patients. Methods Databases including PubMed, EMbase, The Cochrane Library (Issue 10, 2016), CNKI, CBM, WanFang Data and CNKI were searched from inception to October 2016 to collect randomized controlled trials (RCTs) of landmark-guided versus ultrasound-guided IJV catheterization in pediatric patients who underwent elective surgery. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of included studies. Then RevMan 5.3 software was used to perform meta-analysis. Results A total of 13 RCTs involving 1 026 pediatric patients were included. The results of meta-analysis showed that, the overall success rate (RR=1.21, 95%CI 1.09 to 1.34, P=0.000 5) and arterial puncture rate (RR=0.19, 95%CI 0.07 to 0.50, P=0.000 7) of US-guided IJV catheterization were both significantly superior to the ALM group. Whereas there was no significant difference between two groups as for the incidence of hematoma formation (RR=0.35, 95%CI 0.09 to 1.31, P=0.12). Conclusion Current evidence shows that, for IJV catheterization of pediatric patients, both the effectiveness and safety of ultrasound-guided technique are better than the landmark-guided. Since the quantity and quality of included studies are limited, the conclusion of this study needs more high quality studies to verify.

Citation： CHIDong-mei, YUHong, LanHai-dan, LIUBin. Effectiveness and Safety of the Ultrasound Guidance for Internal Jugular Vein Catheterization in Pediatric Patients: A Meta-analysis. Chinese Journal of Evidence-Based Medicine, 2016, 16(12): 1465-1471. doi: 10.7507/1672-2531.20160219 Copy

1.	McGee DC, Gould MK. Preventing complications of central venous catheterization. N Engl J Med, 2003, 348(12):1123-1133.
2.	Sznajder JI, Zveibil FR, Bitterman H, et al. Central vein catheterization. Failure and complication rates by three percutaneous approaches. Arch Intern Med, 1986, 146(2):259-261.
3.	Hind D, Calvert N, McWilliams R, et al. Ultrasonic locating devices for central venous cannulation:meta-analysis. BMJ, 2003, 327(7411):361.
4.	Peris A, Zagli G, Bonizzoli M, et al. Implantation of 3951 long-term central venous catheters:performances, risk analysis, and patient comfort after ultrasound-guidance introduction. Anesth Analg, 2010, 111(5):1194-1201.
5.	Karakitsos D, Labropoulos N, De Groot E, et al. Real-time ultrasound-guided catheterisation of the internal jugular vein:a prospective comparison with the landmark technique in critical care patients. Crit Care, 2006, 10(6):R162.
6.	Stang A. Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses. Eur J Epidemiol, 2010, 25(9):603-605.
7.	Chuan WX, Wei W, Yu L. A randomized-controlled study of ultrasound prelocation vs anatomical landmark-guided cannulation of the internal jugular vein in infants and children. Pediatric Anesthesia, 2005, 15(9):733-738.
8.	Grebenik CR, Boyce A, Sinclair ME, et al. NICE guidelines for central venous catheterization in children. Is the evidence base sufficient. Br J Anaesth, 2004, 92(6):827-830.
9.	Ovezov A, Zakirov I, Vishnyakova M, et al. Effectiveness and safety of the internal jugular vein catheterization in pediatrics:Ultrasound navigation vs anatomical landmarks (A prospective, randomized, double-blind study). Intensive Care Med, 2010;3(6):S275.
10.	Tempe DK, Hasija S, Malik I, et al. Use of Transthoracic Echocardiography Probe for Locating the Internal Jugular Vein to Assist Cannulation In Children and Its Comparison With the Standard Landmark Technique. MAMC J Med Sci, 2015, 1(1):20-24.
11.	Verghese ST, McGill WA, Patel RI, et al. Ultrasound-guided Internal Jugular Venous Cannulation in Infants A Prospective Comparison with the Traditional Palpation Method. Anesthesiology, 1999, 91(1):71-77.
12.	Verghese ST, McGill WA, Patel RI, et al. Comparison of three techniques for internal jugular vein cannulation in infants. Pediatri Anesth, 2000, 10(5):505-511.
13.	刘国亮, 张建敏. 超声定位在婴幼儿颈内静脉穿刺置管中的应用. 临床麻醉学杂志, 2013, 29(04):359-361.
14.	李翠芝, 徐传果. 超声引导下颈内静脉置管在婴儿心脏手术中的应用. 临床麻醉学杂志, 2010, 26(07):598-599.
15.	李颖. 超声在先天性心脏病患儿颈内静脉穿刺置管术中的应用. 吉林医学, 2011, 32(34):7255-7256.
16.	梁勇升, 唐培佳, 谭冠先. 超声定位在小儿颈内静脉穿刺置管中的应用. 临床麻醉学杂志, 2011, 27(07):695-696.
17.	游仁芳, 李巧云, 谢平. 心脏手术患儿超声引导右颈内静脉穿刺置管术的效果. 南昌大学学报(医学版), 2013, 53(12):56-58.
18.	赵亮阳, 黄文. 超声引导在先天性心脏病婴幼儿颈内静脉穿刺置管术中的应用. 中国现代医药杂志, 2013, 15(4):26-28.
19.	赵柏松, 孟凌新, 邢准, 等. 超声引导在患儿颈内静脉穿刺置管中的应用. 临床麻醉学杂志, 2012, 28(09):891-893.
20.	Palepu GB, Deven J, Subrahmanyam M, et al. Impact of ultrasonography on central venous catheter insertion in intensive care. Indian J Radiol Imaging, 2009, 19(3):191-198.
21.	Troianos CA, Hartman GS, Glas KE, et al. Councils on Intraoperative Echocardiography and Vascular Ultrasound of the American Society of Echocardiography:Guidelines for performing ultrasound guided vascular cannulation:recommendations of the American Society of Echocardiography and the Society of Cardiovascular Anesthesiologists. J Am Soc Echocardiogr, 2011, 24(12):1291-1318.
22.	Shime N, Hosokawa K, MacLaren G. Ultrasound imaging reduces failure rates of percutaneous central venous catheterization in children. Pediatr Crit Care Med, 2015, 16(8):718-725.

1. McGee DC, Gould MK. Preventing complications of central venous catheterization. N Engl J Med, 2003, 348(12):1123-1133.
2. Sznajder JI, Zveibil FR, Bitterman H, et al. Central vein catheterization. Failure and complication rates by three percutaneous approaches. Arch Intern Med, 1986, 146(2):259-261.
3. Hind D, Calvert N, McWilliams R, et al. Ultrasonic locating devices for central venous cannulation:meta-analysis. BMJ, 2003, 327(7411):361.
4. Peris A, Zagli G, Bonizzoli M, et al. Implantation of 3951 long-term central venous catheters:performances, risk analysis, and patient comfort after ultrasound-guidance introduction. Anesth Analg, 2010, 111(5):1194-1201.
5. Karakitsos D, Labropoulos N, De Groot E, et al. Real-time ultrasound-guided catheterisation of the internal jugular vein:a prospective comparison with the landmark technique in critical care patients. Crit Care, 2006, 10(6):R162.
6. Stang A. Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses. Eur J Epidemiol, 2010, 25(9):603-605.
7. Chuan WX, Wei W, Yu L. A randomized-controlled study of ultrasound prelocation vs anatomical landmark-guided cannulation of the internal jugular vein in infants and children. Pediatric Anesthesia, 2005, 15(9):733-738.
8. Grebenik CR, Boyce A, Sinclair ME, et al. NICE guidelines for central venous catheterization in children. Is the evidence base sufficient. Br J Anaesth, 2004, 92(6):827-830.
9. Ovezov A, Zakirov I, Vishnyakova M, et al. Effectiveness and safety of the internal jugular vein catheterization in pediatrics:Ultrasound navigation vs anatomical landmarks (A prospective, randomized, double-blind study). Intensive Care Med, 2010;3(6):S275.
10. Tempe DK, Hasija S, Malik I, et al. Use of Transthoracic Echocardiography Probe for Locating the Internal Jugular Vein to Assist Cannulation In Children and Its Comparison With the Standard Landmark Technique. MAMC J Med Sci, 2015, 1(1):20-24.
11. Verghese ST, McGill WA, Patel RI, et al. Ultrasound-guided Internal Jugular Venous Cannulation in Infants A Prospective Comparison with the Traditional Palpation Method. Anesthesiology, 1999, 91(1):71-77.
12. Verghese ST, McGill WA, Patel RI, et al. Comparison of three techniques for internal jugular vein cannulation in infants. Pediatri Anesth, 2000, 10(5):505-511.
13. 刘国亮, 张建敏. 超声定位在婴幼儿颈内静脉穿刺置管中的应用. 临床麻醉学杂志, 2013, 29(04):359-361.
14. 李翠芝, 徐传果. 超声引导下颈内静脉置管在婴儿心脏手术中的应用. 临床麻醉学杂志, 2010, 26(07):598-599.
15. 李颖. 超声在先天性心脏病患儿颈内静脉穿刺置管术中的应用. 吉林医学, 2011, 32(34):7255-7256.
16. 梁勇升, 唐培佳, 谭冠先. 超声定位在小儿颈内静脉穿刺置管中的应用. 临床麻醉学杂志, 2011, 27(07):695-696.
17. 游仁芳, 李巧云, 谢平. 心脏手术患儿超声引导右颈内静脉穿刺置管术的效果. 南昌大学学报(医学版), 2013, 53(12):56-58.
18. 赵亮阳, 黄文. 超声引导在先天性心脏病婴幼儿颈内静脉穿刺置管术中的应用. 中国现代医药杂志, 2013, 15(4):26-28.
19. 赵柏松, 孟凌新, 邢准, 等. 超声引导在患儿颈内静脉穿刺置管中的应用. 临床麻醉学杂志, 2012, 28(09):891-893.
20. Palepu GB, Deven J, Subrahmanyam M, et al. Impact of ultrasonography on central venous catheter insertion in intensive care. Indian J Radiol Imaging, 2009, 19(3):191-198.
21. Troianos CA, Hartman GS, Glas KE, et al. Councils on Intraoperative Echocardiography and Vascular Ultrasound of the American Society of Echocardiography:Guidelines for performing ultrasound guided vascular cannulation:recommendations of the American Society of Echocardiography and the Society of Cardiovascular Anesthesiologists. J Am Soc Echocardiogr, 2011, 24(12):1291-1318.
22. Shime N, Hosokawa K, MacLaren G. Ultrasound imaging reduces failure rates of percutaneous central venous catheterization in children. Pediatr Crit Care Med, 2015, 16(8):718-725.

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