Central venous line insertion in neonates is an important and lifesaving procedure. It can carry significant risks and complications, including death, at the time of insertion or later. We aimed to retrospectively assess the modified Seldinger technique for open placement of a central venous catheter in neonates, regarding its safety, feasibility, operative time, and preservation of the patency of the internal jugular vein. This study was conducted on 120 neonates from March 2018 to March 2020. We closely monitored the pulse for the detection of arrhythmia or bradycardia, which might be caused during the insertion of the guide wire or the tip of the catheter. Post-operative X-ray was done immediately after the end of the procedure for all cases, to determine the site of the central venous catheter and to detect the presence of pneumothorax. Arrhythmia was observed in 9 cases (7.5%), and blood oozing in 5 cases (4.1%). There were 3 cases of pneumothorax (2.5%), 2 cases of neck hematoma in two cases (1.6%), 6 cases of internal jugular vein thrombosis (5%), and dislodging of the catheter in 3 cases (2.5%). There were no cases of arterial puncture, failure of cannulation, or haemothorax in our study. The modified Seldinger technique insertion for open central venous line in neonates is a safe, accessible, and feasible method, especially in centers that lack the experience of ultrasound-guided insertion in neonates.

中文翻译：

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用于新生儿颈内开放中心静脉导管的改良 Seldinger 技术：合并两种不同的操作

新生儿中心静脉导管插入是一项重要的救生手术。它可能会在插入时或之后带来重大风险和并发症，包括死亡。我们旨在回顾性评估改良 Seldinger 技术用于在新生儿中开放放置中心静脉导管的安全性、可行性、手术时间和颈内静脉通畅的保护。本研究于 2018 年 3 月至 2020 年 3 月对 120 名新生儿进行。我们密切监测脉搏以检测心律失常或心动过缓，这可能是在插入导丝或导管尖端期间引起的。所有病例在手术结束后立即进行术后 X 线检查，以确定中心静脉导管的位置并检测是否存在气胸。出现心律失常9例（7.5%），渗血5例（4.1%）。气胸3例（2.5%），颈部血肿2例（1.6%），颈内静脉血栓6例（5%），导管脱落3例（2.5%）。我们的研究中没有发生动脉穿刺、插管失败或血胸的病例。改良的 Seldinger 技术插入新生儿开放中心静脉是一种安全、可及且可行的方法，尤其是在缺乏新生儿超声引导插入经验的中心。我们的研究中没有发生动脉穿刺、插管失败或血胸的病例。改良的 Seldinger 技术插入新生儿开放中心静脉是一种安全、可及且可行的方法，尤其是在缺乏新生儿超声引导插入经验的中心。我们的研究中没有发生动脉穿刺、插管失败或血胸的病例。改良的 Seldinger 技术插入新生儿开放中心静脉是一种安全、可及且可行的方法，尤其是在缺乏新生儿超声引导插入经验的中心。