Aim: Maintaining continuous intravenous access is essential for critically ill children, particularly in emergencies. Central venous catheter insertion can be performed under ultrasound guidance or using the landmark technique. The main goal of this study is to compare the outcomes between ultrasound-guided and landmark techniques for central venous catheter insertion.

Study Design: Patients admitted to the pediatric intensive care unit between April 2021 and April 2023 requiring central vascular access to the internal jugular vein were included in the study. The patients were divided into two groups based on the catheter insertion method: the landmark technique (Group I) and ultrasound-guided technique (Group II). All catheterization procedures were performed by the same team of healthcare providers. Outcomes evaluated included demographic data, successful catheter insertion, and the occurrence of complications.

Results: A total of 126 internal jugular vein catheterization procedures were included in this study. In Group I, the mean hemoglobin level before catheter insertion was 10.32±2.37 g/dL, and the mean hemoglobin level after catheter insertion was 9.25±1.82 g/dL. In Group II, the mean hemoglobin level before catheter insertion was 11.70±1.28 g/dL, and the mean hemoglobin level after catheter insertion was 11.25±1.28 g/dL. The decrease in hemoglobin levels was statistically significant (p=0.01). Similarly, the reduction in platelet count was greater in Group I (328,723.40±167,272.84 vs. 272,170.21±141,128.72) than in Group II (273,886.08±140,184.31 vs. 261,126.58±143,932.17), and this difference was also statistically significant (p=0.01).

Conclusions: The findings indicate that ultrasound-guided catheterization reduces complications associated with catheter insertion. Therefore, ultrasound-guided catheterization is highly recommended for critically ill children.