Guía práctica para la colocación ecográfica de accesos venosos y arteriales en pediatría. Recomendaciones GAVA

Abstract: Vascular access is essential in critically ill pediatric patients for the administration of life-saving treatments, monitoring, and blood sampling. Traditional placement of venous and arterial access based on anatomical landmarks is associated with complications due to its blind execution. Bedside ultrasound has revolutionized the practice, allowing real-time visualization of the vessel and needle, increasing success rates, and reducing complications. A standardized guide is presented for vascular access placement, which includes prior evaluation, equipment preparation, positioning of the operator and the vessel to be used, ultrasound-guided puncture, catheter placement, and post-procedure verification. The most common access modalities (internal jugular vein, subclavian, and femoral), unusual situations, arterial catheters, early detection of complications, and the final position of the catheter’s distal tip are included, there by improving safety and effectiveness, and reducing the need for radiation exposure. Additionally, the importance of simulation-based training and standardization of the procedure to maintain safety and effectiveness is emphasized. The use of ultrasound in the placement of pediatric access points is the technique of choice due to its superiority in safety and success compared to traditional methods. The integration of detailed guidelines, ongoing clinical training, and the use of advanced techniques such as contrast-enhanced ultrasound optimize outcomes and minimize complications. The inclusion of these skills in the training of specialists in intensive care, emergency medicine, and pediatric surgery is recommended to standardize and improve the quality of care.