Ultrasound-guided insertion of peripherally inserted central catheter after anesthetic induction in children undergoing surgery for moyamoya disease - Thirty cases report

Abstract

Background: Pediatric patients with moyamoya disease are vulnerable to ischemic attacks following physical or emotional stress, such as those experienced during blood sampling. A central venous catheter might be beneficial for blood sampling, and a peripherally inserted central catheter (PICC) is a considerable option for central venous access. However, PICC insertion during anesthetic management is relatively rare.

Case: Thirty cases of ultrasound-guided PICC insertion were performed in children undergoing surgery for moyamoya disease after anesthetic induction. Positioning was successful in 22 cases, and 5 were malpositioned. In three cases, the peripheral insertion failed. Adjustment of the insertion depth was performed in nine cases. No complications related to catheterization were observed during the procedure or the catheter indwelling period.

Conclusions: We report the successful use of PICC in children undergoing surgery for moyamoya disease with a considerable success rate and low incidence of malpositioning or complications.

Keywords: Central venous catheterization; Children; General anesthesia; Moyamoya disease; Neurosurgery; Ultrasonography.

Fig. 1.

Examples of postoperative chest radiographs for confirmation of the tip of peripherally inserted central catheters. The tip is located at the superior vena cava (A), ipsilateral internal jugular vein (B), and contralateral brachiocephalic vein (C).