Comparison of ultrasound-guided versus anatomical landmark-guided cannulation of the femoral vein at the optimum position in infants

Abstract

Background Femoral vein cannulation may be required during major surgery in infants and children and may prove to be life saving under certain conditions. This study compared ultrasound (US)-guided cannulation of the femoral vein in infants with the traditional anatomical landmark-guided technique.
Methods Eighty infants who had been prepared for a major elective surgery under general anesthesia were randomly assigned to either group I, in which the femoral vein cannulation was guided by anatomical landmarks in optimally positioned patients, or group II, in which an US-guided technique was used for cannulation.
Results The procedure was successful in 35 cases in group I and in all cases in group II. The number of needle passes was higher in group I compared with that in group II [four (1–22) vs. one (1–8); P = 0.001]. First-pass success was achieved in 20 cases in group I and in 35 cases in group II. The time to complete cannulation was significantly shorter in group II compared with that in group I [145 (40–650) s vs. 350 (40–1600) s; P = 0.02]. Three cases of arterial puncture occurred in group I, whereas there were no complications in group II.
Conclusion US-guided techniques for femoral vein cannulation are useful as they result in greater success, shorter cannulation times, less number of attempts, and lower complication rates. 

Keywords: anatomical, cannulation, femoral vein, infants, ultrasonic