Cannulation via the external jugular vein--An alternative to conventional peripherally inserted central catheterisation for paediatric patients

Comparison of the patency rates of catheter placement via the right external jugular vein route versus the right brachiocephalic vein route in patients experiencing tunneled-cuffed catheter loss

INTRODUCTION

The aim of this study is to compare the patency rates of catheter placement via cannulation of right external jugular vein (EJV) versus the right brachiocephalic (BCV) in patients experiencing tunneled-cuffed catheter (TCC) loss.

METHOD

We conducted a retrospective analysis of 30 patients admitted to our department due to TCC loss. Among them, 11 patients underwent catheter reinsertion via the right EJV, while 19 patients underwent catheter reinsertion via the right BCV. We collected and compared the data of these patients.

RESULTS

In both groups of patients, there were no cases of pneumothorax, severe adjacent artery injury, or mediastinal hematoma observed. The one-year primary patency rates of the catheters in the EVJ group and the BCV group were 54.55% and 36.84%, and the primary patency rates of two years were found to be 27.27% and 21.05% respectively. There was no statistically significant difference in the patency rates at both 1 and 2 years (p = 0.55, p = 0.71).

CONCLUSION

In the face of patients experiencing TCC loss, the practice of replacing dialysis catheters via the right EJV and right BCV routes emerges as a safe and efficacious alternative strategy. Notably, no difference in catheter patency rates is observed between these divergent access routes.

Conventional Radiology Evaluation of Neonatal Intravascular Devices (NIVDs): A Case Series

Our radiology department conducted an assessment of 300 neonatal radiographs in the neonatal intensive care unit over almost two years. The purpose was to evaluate the correct positioning of intravascular venous catheters. Our case series revealed that out of a total of 95 cases with misplaced devices, 59 were umbilical venous catheters and 36 were peripherally inserted central catheters. However, all of the central venous catheters were found to be properly positioned. Misplacements of neonatal intravascular devices were found to occur more frequently than expected. The scientific literature contains several articles highlighting the potential complications associated with misplaced devices. Our goal is to highlight the potential misplacements and associated complications that radiologists may encounter while reviewing conventional radiology imaging. Based on our experience, which primarily involved placing UVCs and PICCs, we discovered that conventional radiology is the most effective method for assessing proper device placement with the lowest possible radiation exposure. Given the high number of neonatal vascular device placement procedures, it is essential for radiologists to maintain a high level of vigilance and stay updated on the latest developments in this field.