Effect of modified right subclavian vein catheterization in children on reducing catheter malposition
WANG Xue-qing
CHEN Yuan-zhen
XU Liang
XU Bo
Abstract：Objective To explore the effectiveness and safety of adjusting patient position and partial withdrawal of the guidewire during catheter placement in reducing catheter malposition.Methods Children undergoing right subcla-vian vein catheterization were randomly divided into two groups:the experimental group(Group A,82 cases)and the control group(Group B,82 cases).In Group A,the patients were in the supine position,and the guidewire was partially withdrawn during catheter insertion.In Group B,the traditional method was used,with the patient in a head-down,foot-up position,and the guidewire fully guiding the catheter.Ultrasound was used intraoperatively to assess the catheter tip di-rection.Results Three patients(2 from Group A and 1 from Group B)required multiple attempts at vascular puncture and were switched to right internal jugular vein catheterization.The accuracy of the catheter tip direction on the first at-tempt(R1)was higher in Group A than in Group B(P＜0.05).The incidence of catheter malposition into the right in-ternal jugular vein on the first attempt(R2)was lower in Group A than in Group B(P＜0.05),with statistically signifi-cant differences between the two groups in R1 and R2.There was no significant difference between the two groups in the incidence of malposition into the left brachiocephalic vein(left subclavian vein)(R3),complications,or general clinical data(P＞0.05).Conclusion The supine position with partial withdrawal of the guidewire during catheter insertion im-proves the accuracy of catheter tip placement in right subclavian vein catheterization in children and is a safe method.
Keywords：childrenright subclavian veincatheter tip
Publication Date：2024-10-28
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 1266-1271 )