Comparison of ultrasound-guided central venous catheterization versus anatomical landmarks in pediatric critically ill patients: a prospective study

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Introduction: central venous catheterization is a common procedure in critically ill pediatric patients, but its accurate and safe performance remains a challenge.Objective: to determine if ultrasound-guided central venous catheterization improves the first-attempt success rate and reduces the risk of complications compared with the landmark-based approach in pediatric critically ill patients.Methods: a prospective study was carried out that included 100 critical pediatric patients, divided into two groups: ultrasound-guided catheterization (n=43) and anatomical references (n=47). Demographic and clinical data were collected, variables of interest were recorded, and logistic regression analysis adjusted for patient age, access site, and operator was performed.Results: ultrasound-guided central venous catheterization showed a significantly higher first-attempt success rate compared with anatomic references (81,4 % vs. 57,4 %, p<0,05). In addition, a significant reduction in procedural complications was observed in the ultrasound-guided group compared to the anatomical reference group (4,7 % vs. 12,8 %, p<0.05).Conclusions: the use of ultrasound as a guide improves the success rate in the first attempt and reduces the risk of complications during the procedure. These findings highlight the importance of considering ultrasound-guided catheterization as a preferred strategy in the management of critically ill pediatric patients requiring central venous access

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