• Pediatr Crit Care Me · Jan 2001

    Complications of central venous catheterization in critically ill children.

    • J Casado-Flores, J Barja, R Martino, A Serrano, and A Valdivielso.
    • Pediatric Intensive Care Unit, Hospital Infantil Niño Jesus, Universidad Autonoma de Madrid, Madrid, Spain.
    • Pediatr Crit Care Me. 2001 Jan 1; 2 (1): 57-62.

    ObjectiveAnalysis of central venous catheterization complications in different access sites with the Seldinger technique. Patients and Methods: A prospective study (May 1992 through December 1996) of 308 central venous catheterizations in children of different ages in a pediatric intensive care unit. ResultsAccess sites were the subclavian vein (76.3%), femoral vein (20.4%), and jugular vein (3.2%). The frequency of catheter placement-related complications was 22%, and the frequency of serious catheter placement-related complications was 2.9% (pneumothorax 1.9%, hemothorax 1%). Catheter placement-related complications were more common in the subclavian than in the femoral vein (chi-square, p =.02) for the larger bore catheters (chi-square, p =.01) and for the higher number of attempts (Student's t -test, p <.001). Catheter placement-related complications were not related to the age, weight, or whether the procedure was performed by the staff physician or resident. The overall complication rate for maintenance-related complications was 36%. Maintenance-related complications were more common in younger children (Student's t -test, p =.03). The most frequent maintenance-related complications were mechanical complications (catheter obstruction and central venous thrombosis), and these were higher for femoral access (chi-square, p <.01) and for catheters indwelling for a longer period of time. Infection was found in 5.8% of patients, mainly due to Staphylococcus epidermidis. Infection was not related to the site of venous access or to the length of time the catheter was left indwelling. ConclusionsCentral venous catheterization can be performed readily in children of all ages with an acceptable degree of risk. The immediate complications were more frequent and severe for subclavian vein catheterization, and the highest risk factor was the number of attempts at catheter insertion. Although the most frequent late complications were mechanical, which were higher for the femoral access and long-indwelling catheters, femoral catheters can be left indwelling for longer periods if routine ultrasound follow-up is performed. Infectious complications were independent of the venous access site or the duration of catheterization.

      Pubmed     Free full text   Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…