Acceso vascular central ecoguiado en pediatría

The placement of central venous catheters in pediatric patients represents a clinical challenge due to anatomical and physiological peculiarities and the high risk of complications. The systematic incorporation of ultrasound has transformed this procedure, allowing direct visualization of vascular structures, optimizing technical precision, and reducing adverse events. This review article addresses the physical fundamentals of ultrasound, catheter selection according to age and anatomy, the technical principles of ultrasound guidance, and specific strategies for each anatomical site (internal jugular, subclavian, and femoral). The GAVeCeLT protocol and its integration with advanced clinical practices are analyzed, as well as the ultrasound evaluation of early and late complications associated with the procedure. Tools such as the triangulation principle, the ECHOTIP-Ped protocol, and functional echocardiography with bubble test are highlighted, which improve the safety and efficacy of central venous catheterization in neonates and children. Current evidence supports the use of ultrasound as an international standard in pediatrics, with a positive impact on clinical outcomes and the technical training of medical personnel.