Ultrasound-Guided Infraclavicular Axillary Vein Cannulation: - Is it a Good Alternative to Internal Jugular Vein Cannulation in Pediatric Cardiac Surgery? .

Objective: This study was designed to compare the rates of successful first attempt and mechanical complications between internal jugular vein (IJV) and axillary vein (AXV) cannulation. Methods: This prospective, randomized, comparative, controlled study included 220 pediatric patients with age range 1 to 12 years scheduled for cardiac surgery. Patients were allocated into 2 equal groups as IJV and AXV groups. The rates of successful first, second and third puncture attempts and the mechanical complications (arterial puncture, pneumothorax, catheter occlusion, catheter malposition, nerve injury) were investigated. Results: There was no statistically significant difference (p=0.053) in the first skin puncture success rates in both groups (AXV group 80% and IJV group 68%). There were no significant differences regarding the second and third skin puncture success rates. The incidence rates of failed vein punctures were similar in IJV (3%) and AXV (2%) groups. The vein puncture and catheter insertion times and the rates. Arterial puncture, pneumothorax and catheter malposition were similar in IJV and AXV groups (12% vs 11%, 4% vs 1%, 3% vs 5% respectively). The rates of catheter occlusion with sternal retraction were significantly higher (p=0.029) in AXV than IJV group (6% vs 0%). Postoperative phrenic (IJV group) or brachial plexus nerve injury (AXV group) was not developed in any patient. Conclusion: Ultrasound-guided cannulation of both infraclavicular AXV and IJV were similarly associated with high success rates and low incidence of mechanical complications. [ABSTRACT FROM AUTHOR]