PP-013 Ultrasound guided central line insertion in level 3 PICU in North India

Aim Ultrasound guided central line insertion in pediatric intensive care unit - experience from North India Material and Method After ethical clearance we evaluated ultrasound guided central line insertion over period of 12 months in level 3 PICU in a study period 2021–2022. Results Out of total 105 patients, majority were in the age 1–5 yrs ( 32.4%), 30 ( < 1 year), 20 ( 6–10 yrs) and 21 (> 10 yrs ) of age. Majority of children (63) were discharged, 21(20%) took discharge against medical advice and 21 died during hospital stay. In the primary system involved, most common system involvement was CNS in 27 patients (25.7%), followed by respiratory in 11(10.5%) and sepsis in 11(10.5%). Central line indication in majority of patients was need for inotropic support. Inotropes were needed in 89(84.8%) children out of 105. Fifty eight patients had single inotropic support compared to multiple inotropes needed in 31 children. Most common site was femoral in 51(48.6%) patients, followed by internal jugular vein in 39(37.1%) and subclavian in 11(10.5%). Most common central line dimensions used were 4 Fr 8 cm which was used in 59(56.1%)patients. Only 5 patients had swelling associated with CVL at local site. One patient had intra cardiac fungal vegetations. One patient had CRBSI( central line related blood stream infections). Majority of children were cannulated in first prick 49(46.7), followed by insertion requiring two pricks in 41(39%) children. Only 10 patients needed third attempt for cannulation. More than 3 attempts were needed in 5 children. Insertions were done by PICU consultant in 22 cases(21%) and PICU fellow in 83(79%) cases. Out of total children ninty one needed ventilator support(86.7%) and 13 (12.4%) required NIV support (table 1). Conclusions Ultrasound guided vascular access is safe technique in sick pediatric patients. It has a high success rate and minimal complications in our setting.