Comparison of ultrasound-guided vs. anatomical landmark-guided cannulation of the femoral vein at the optimum position in infant

Background: Femoral vein cannulation can be a routine process during major surgery in infants and children, and may prove to be lifesaving under certain conditions. This study compared ultrasound (US)-guided cannulation of the femoral vein in infants with the traditional anatomical landmark-guided technique. Method: Eighty infants who had been prepared for major elective surgery under general anaesthesia were randomly assigned either to Group I, in which the femoral vein cannulation was guided by anatomical landmarks in optimally positioned patients, or to Group II in which the US-guided technique was used for cannulation. Results: The procedure was successful in 35 cases in Group I, and in all cases in Group II. The number of needle passes was higher in Group I, compared to Group II [4 (1-22) vs. 1 (1-8); p-value = 0.001]. First-pass success was achieved in 20 cases in Group I, and in 35 cases in Group II. The time to complete cannulation was significantly shorter in Group II, compared to Group I [145 (40-650) vs. 350 (40-1 600) seconds; p-value = 0.02]. Three cases of arterial puncture occurred in Group I, while there were no complications in Group II. Conclusion: The US-guided technique for femoral vein cannulation is useful as it results in greater success, shorter cannulation times, fewer attempts, and fewer complications.