Journal of Anaesthesiology Clinical Pharmacology · Published 2026-05-19 · DOI 10.4103/joacp.joacp_492_25
Uditi Parmar, Swarup Ray, Raylene Dias
Background and Aims: Central venous cannulation in neonates and infants is technically challenging due to small vessel size and vein collapsibility. Although ultrasound-guided (USG) internal jugular vein (IJV) cannulation is commonly used, supraclavicular in-plane brachiocephalic vein (BCV) cannulation has emerged as a newer approach with several advantages because of its straighter course, larger diameter, and reduced collapsibility. The aim of this study was to compare the USG-guided in-plane IJV vs supraclavicular in-plane BCV cannulation in neonates and infants. Material and Methods: This prospective randomized controlled trial (RCT) was commenced after obtaining institutional ethical clearance (EC/OA-67/2022) and registered with CTRI (REF/2023/08/071780). A total of 80 neonates and infants satisfying the eligibility criteria were included for this study, with 40 each being randomly allotted either to group A (USG in-plane right IJV cannulation) or group B (USG supraclavicular in-plane left BCV cannulation). Written informed parental consent was obtained for all the participants. The primary outcome was 1st attempt success rate. Secondary outcomes included cannulation time, number of attempts, overall success rate, and complications. Results: First-attempt success rate was higher in BCV than in the IJV group (95% vs 77.50%, P value = 0.02) (95% CI: 3.2–31.8). Cannulation time was less in the BCV group (50.70 ± 58.51 secs vs 86.63 ± 60.19 secs: P value < 0. 008) (95% CI: −62.5 to −9.3) as compared to the IJV group. Overall success rate was slightly higher in the BCV group (100% vs 97.50%, P value = 0.31) (95% CI: −2.4% to 7.4%) along with a reduced number of attempts (1.08 ± 0.35 vs 1.30 ± 0.65, P value = 0.057) (95% CI: −0.45 to 0.01). No immediate or late complications (within 48 hours) were observed in both the groups. Conclusions: USG in-plane left BCV cannulation improved first-attempt success rate and cannulation time as compared to in-plane right IJV cannulation with a reduced number of attempts. Brachiocephalic central venous cannulation may have advantages over IJV access, especially in critically ill neonates and infants, making it a feasible and safe alternative to IJV.
Abstract from DOAJ. Public domain (CC0 1.0).
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Parmar, U., Ray, S., Dias, R. (2026). Comparison of ultrasound-guided brachiocephalic and internal jugular vein cannulation in neonates and infants: A prospective randomized controlled trial. Journal of Anaesthesiology Clinical Pharmacology. https://doi.org/10.4103/joacp.joacp_492_25