Anatomy of Femoral Vessels in Infants and Guidelines for Venous Catheterization

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Abstract
This study was performed to formulate femoral venous catheterization guidelines for infants from ultrasound observations. Femoral vessels were evaluated on both sides in 75 infants, 2 weeks to 24 months of age. The site of the greatest probability of successful venipuncture 1 cm below the skin crease at the groin is located 4 to 5 mm medial to the femoral artery pulse. If it is assumed that entry into the central half of the vein will result in successful catheterization, successive attempts 5 mm and 6 mm medial to the pulse would result in cumulative successful insertion in 53% and 61%, respectively, with no arterial punctures. A third attempt 4 mm medial to the pulse further increases cumulative success to 78%, but 3% arterial punctures would occur. These guidelines are intended to facilitate achievement of femoral venous catheterization, minimizing arterial punctures and number of needle passes required.

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