What is the need to place a vascular access for anaesthetic procedures in children?
Abstract
Introduction:
Vascular access in children has been considered an essential part of safe in paediatric anaesthesia. However, it requires great skill and it has risks and complications. There is a current controversy about when it is required, especially in patients in whom access is difficult and are scheduled for minor and short-term procedures.
Objective:
To reflect on the factors that must be considered regarding the placement of peripheral vascular access in children for peri-operative management, and to provide tools to help with the decision of placing a vascular access.
Methodology:
A non systematic review was made to find the indications and risks of vascular access; and a reflection on the main considerations to think about when it is necessary to place a vascular access in children.
Results:
The review of the literature resulted in relevant considerations that need to be emphasised when deciding to place a vascular access in children.
Conclusion:
The risk and benefit of any intervention in children should be assessed. The final decision to place a venous access for peri-operative management of children depends on patient age, degree of difficulty of the vascular access, type of procedure, duration and, finally, the anaesthetist's own perception of safety. Individual experience counts when it comes to the final decision.
References
2. Stovroff M, Gerald Teague W. Intravenous access in infants and children. Pediatr Clin N Am. 1998;45:1373-93.
3. Shlamovitz GZ, Shlamovitz GZ. Pediatric intravenous cannulation; 2017. Available from: http://emedicine.medscape.com/article/2008690-overview [cited 18.03.17].
4. Scott-Warren VL, MBChB (Hons) FRCA, Morley RB, BM FRCA. Paediatric vascular access. BJA Educ. 2015;15:199-206.
5. Farrelly JS, Stitelman DH. Complications in pediatric enteral and vascular access. Semin Pediatr Surg. 2016:371-9.
6. Lininger RA. Pediatric peripheral i.v. insertion success rates. Pediatr Nurs. 2003;29:351-4.
7. Rauch D, Dowd D, Eldridge D, Mace S, Schears G, Yen K. Peripheral difficult venous access in children. Clin Pediatr (Phila). 2009;48:895-901.
8. Clinical Practice Guideline: Difficult Intravenous Access. Emergency Nurses Association; 2017. Available from: https://www.ena.org/practice./CPG/./difficultivaccesscpg.pdf [cited 21.03.17].
9. Roushdy A, Abdelmonem N, El Fiky A. Factors affecting vascular access complications in children undergoing congenital cardiac catheterization. Cardiol Young. 2012;22:136-44.
10. Wilson G, Engelhardt T. Who needs an IV? Retrospective service analysis in a tertiary pediatric hospital. Pediatr Anesth. 2012;22:442-4.
11. Barnett S, Moloney C, Bingham R. Perioperative complications in children with Apert syndrome: a review of 509 anesthetics. Pediatr Anesth. 2011;21:72-7.
12. Smith J. The placement of an intravenous cannula is always necessary during general anesthesia in children: a pro-condebate. The case against. Paediatr Anaesth. 2012;22: 455-8.
13. Petroski A, Frisch A, Joseph N, Carlson JN. Predictors of difficult pediatric intravenous access in a community emergency department. J Vasc Access. 2015;16:521-6.
14. Cole I, Glass C, Norton HJ, Tayal V. Ultrasound measurements of the saphenous vein in the pediatric emergency department population with comparison to i.v. catheter size. J Emerg Med. 2012;43:87-92.
15. Ares G 1, Hunter CJ. Central venous access in children: indications, devices, and risks. Curr Opin Pediatr. 2017;29:340-6.
16. Hosokawa K, Kato H, Kishi C, Kato Y, Shime N. Transillumination by light-emitting diode facilitates peripheral venous cannulations in infants and small children. Acta Anaesthesiol Scand. 2010;54:957-61.
17. Graaff JC, Cuper NJ, Mungra RA, Vlaardingerbroek K, Numan SC, Kalkman CJ. Near-infrared light to aid peripheral intravenous cannulation in children: a cluster randomised clinical trial of three devices. Anaesthesia. 2013;68: 835-45.
18. Rothbart A, Yu P, Müller-Lobeck L, Spies CD, Wernecke KD, Nachtigall I. Peripheral intravenous cannulation with support of infrared laser vein viewing system in a pre-operation setting in pediatric patients. BMC Res Notes. 2015;8:463.
19. Tripathi S, Kaushik V, Singh V. Peripheral IVs: factors affecting complications and patency. A randomized controlled trial. J Infus Nurs. 2008;31:182-8.
20. Bhananker SM, Ramamoorthy C, Geiduschek JM, Posner KL, Domino KB, Haberkern CM, et al. Anesthesia-related cardiac arrest in children: update from the pediatric perioperative cardiac arrest registry. Anesth Analg. 2007;105: 344-50.
21. Dobson A, Tennuci C. Safe general anaesthesia without secure intravenous access. Anaesthesia. 2015; 70:634.
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