Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2024 Mar;183(3):1073-1078.
doi: 10.1007/s00431-023-05378-2. Epub 2023 Dec 20.

Point-of-care ultrasound for vascular access in neonates and children

Mauro Pittiruti  1 , Maria Giuseppina Annetta  2 , Vito D'andrea  3
Affiliations
Review

Point-of-care ultrasound for vascular access in neonates and children

Mauro Pittiruti et al. Eur J Pediatr. 2024 Mar.

Abstract

Ultrasound plays a major role in neonatal/pediatric vascular access, both for venous access and for arterial access, not only just for the insertion of intravascular catheters, but also for many other issues related to this type of maneuver. This "global use of ultrasound" includes a systematic and consistent adoption of this technology for several steps of vascular access: (a) the pre-procedural assessment/evaluation of the vessels, (b) the ultrasound-guided puncture and cannulation of arteries and veins, (c) the real-time diagnosis of immediate, puncture-related complications, (d) the so-called "tip navigation" (i.e., real-time intra-procedural assessment of the direction and trajectory of the guidewire and/or of the catheter inside the vasculature), (e) the so-called "tip location" (i.e., intra-procedural or post-procedural assessment of the proper position of the tip of the catheter), and (f) the early diagnosis and/or management of most non-infective late complications.

Conclusion: Therefore, any vascular access expert (nurse or physicians) should have documented competency in the use of ultrasound. This knowledge should include the use of ultrasound for assessment of vessels, for catheter insertion, for proper placement of the tip, and for real-time detection of complications.

What is known: • Ultrasound is obviously useful for vascular access procedures in neonates and children.

What is new: • Recent evidence suggests that ultrasound is useful for many purposes in the field of vascular access (preprocedural scan, ultrasound-guided puncture, tip navigation, tip location, diagnosis of most non-infective complications). • Recent evidence also suggests that radiological methods no longer play any role in the insertion of vascular accesses in neonates and children.

Keywords: Central venous catheterization; Children; Infants; Neonates; Tip location; Ultrasound guidance; Vascular access.

PubMed Disclaimer

References

    1. Lamperti M, Bodenham AR, Pittiruti M, Blaivas M, Augoustides JG, Elbarbary M, Pirotte T, Karakitsos D, Ledonne J, Doniger S, Scoppettuolo G, Feller-Kopman D, Schummer W, Biffi R, Desruennes E, Melniker LA, Verghese ST (2012) International evidence-based recommendations on ultrasound-guided vascular access. Intensive Care Med 38(7):1105–1117. https://doi.org/10.1007/s00134-012-2597-x . Epub 2012 May 22 PMID: 22614241 - DOI - PubMed
    1. Crocoli A, Tornesello A, Pittiruti M, Barone A, Muggeo P, Inserra A, Molinari AC, Grillenzoni V, Durante V, Cicalese MP, Zanazzo GA, Cesaro S (2015) Central venous access devices in pediatric malignancies: a position paper of Italian Association of Pediatric Hematology and Oncology. J Vasc Access 16(2):130–136. https://doi.org/10.5301/jva.5000314 . Epub 2014 Oct 14 PMID: 25362978 - DOI - PubMed
    1. Lamperti M, Biasucci DG, Disma N, Pittiruti M, Breschan C, Vailati D, Subert M, Traškaitė V, Macas A, Estebe JP, Fuzier R, Boselli E, Hopkins P (2020) European Society of Anaesthesiology guidelines on peri-operative use of ultrasound-guided for vascular access (PERSEUS vascular access). Eur J Anaesthesiol 37(5):344–376. https://doi.org/10.1097/EJA.0000000000001180.Erratum.In:EurJAnaesthesiol... . PMID: 32265391 - DOI - PubMed
    1. Cellini M, Bergadano A, Crocoli A, Badino C, Carraro F, Sidro L, Botta D, Pancaldi A, Rossetti F, Pitta F, Cesaro S (2022) Guidelines of the Italian Association of Pediatric Hematology and Oncology for the management of the central venous access devices in pediatric patients with onco-hematological disease. J Vasc Access 23(1):3–17. https://doi.org/10.1177/1129729820969309 . Epub 2020 Nov 10 PMID: 33169648 - DOI - PubMed
    1. Singh Y, Tissot C, Fraga MV, Yousef N, Cortes RG, Lopez J, Sanchez-de-Toledo J, Brierley J, Colunga JM, Raffaj D, Da Cruz E, Durand P, Kenderessy P, Lang HJ, Nishisaki A, Kneyber MC, Tissieres P, Conlon TW, De Luca D (2020) International evidence-based guidelines on point of care ultrasound (POCUS) for critically ill neonates and children issued by the POCUS Working Group of the European Society of Paediatric and Neonatal Intensive Care (ESPNIC). Crit Care 24(1):65. https://doi.org/10.1186/s13054-020-2787-9 . PMID:32093763;PMCID:PMC7041196 - DOI - PubMed - PMC

LinkOut - more resources