Utility of Ultrasound-guided Central Venous Cannulation in Pediatric Surgical Patients in Comparison to Landmark Technique

Abstract Background and Objective: Central venous cannulation (LCVC) is a critical procedure in pediatriccardiac surgery that requires precise technique to ensure patient safety and proceduralsuccess. This study aimed to compare the effectiveness and safety of ultrasound LUSG)guidance versus the traditional landmark LLM) technique for central venous cannulation inpediatric cardiac surgical patients undergoing internal jugular vein LIJV) cannulation. Materials and Methods: A prospective observational study was conducted involving 100pediatric patients scheduled for cardiac surgery requiring central venous access. Participantswere systematically divided into two equal groups of 50 patients each. Group I underwent IJVcannulation using ultrasound guidance, while Group II received cannulation using theconventional landmark technique. Key outcome measures included time required for successfulguidewire placement within the internal jugular vein, number of skin punctures required forsuccessful cannulation, and incidence of procedural complications including inadvertent arterialpuncture, pneumothorax, and hemothorax. Statistical analysis was performed to evaluate thesignificance of differences between the two groups. Results: The ultrasound-guided approach demonstrated superior performance across multipleparameters. First-attempt success rate for IJV cannulation was significantly higher in Group Icompared to Group II (72% versus 48%, P = 0.012). The time required for successfulcannulation was significantly reduced in the ultrasound-guided group, with Group I requiring 189seconds compared to 265 seconds in Group II ( P = 0.016). While overall complication rates didnot reach statistical significance between the groups, Group II showed a trend toward highercomplication rates, suggesting potential safety advantages of the ultrasound-guided approach. Conclusion: This study provides compelling evidence that ultrasound guidance significantlyimproves central venous cannulation outcomes in pediatric cardiac surgical patients. The USGtechnique demonstrated enhanced success rates, improved procedural efficiency, and bettersafety profiles compared to the traditional landmark method, supporting its adoption as thepreferred approach for pediatric cardiac surgery patients requiring central venous access.