Abstract
Background
Ultrasound-guided central venous puncture and fluoroscopic guidance during central venous catheter (CVC) positioning optimizes technical success and lowers the complication rates in children, and is therefore considered standard practice.
Objective
The purpose of this study was to compare the radiation exposure levels recorded during CVC placement in children weighing less than 10 kg in procedures performed using an image intensifier-based angiographic system (IIDS) to those performed in a flat-panel detector-based interventional suite (FPDS).
Materials and methods
A retrospective review of 96 image-guided CVC placements, between January 2008 and October 2013, in 49 children weighing less than 10 kg was performed. Mean age was 8.2 ± 4.4 months (range: 1–22 months). Mean weight was 7.1 ± 2.7 kg (range: 2.5–9.8 kg). The procedures were classified into two categories: non-tunneled and tunneled CVC placement.
Results
Thirty-five procedures were performed with the IIDS (21 non-tunneled CVC, 14 tunneled CVC); 61 procedures were performed with the FPDS (47 non-tunneled CVC, 14 tunneled CVC). For non-tunneled CVC, mean DAP was 113.5 ± 126.7 cGy cm2 with the IIDS and 15.9 ± 44.6 cGy · cm2 with the FPDS (P < 0.001). For tunneled CVC, mean DAP was 84.6 ± 81.2 cGy · cm2 with the IIDS and 37.1 ± 33.5 cGy cm2 with the FPDS (P = 0.02).
Conclusion
The use of flat-panel angiographic equipment reduces radiation exposure in small children undergoing image-guided CVC placement.
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Miraglia, R., Maruzzelli, L., Cortis, K. et al. Comparison between radiation exposure levels using an image intensifier and a flat-panel detector-based system in image-guided central venous catheter placement in children weighing less than 10 kg. Pediatr Radiol 45, 235–240 (2015). https://doi.org/10.1007/s00247-014-3119-5
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DOI: https://doi.org/10.1007/s00247-014-3119-5