Percutaneous central venous catheterisation in critically ill children

Area of Science:

• Pediatric Critical Care Medicine
• Vascular Access Procedures
• Infectious Disease Control

Background:

• Central venous catheters are essential for managing critically ill children.
• Assessing the safety and efficacy of different insertion sites is crucial.
• The femoral approach is often considered for central venous access in pediatric patients.

Purpose of the Study:

• To evaluate the success rates and complication incidence of percutaneously placed central venous catheters in critically ill children.
• To compare the outcomes between femoral and non-femoral central venous catheterizations.
• To determine the preferred insertion site for central venous access in pediatric critical care.

Main Methods:

• An 18-month retrospective analysis of 52 central venous catheters in 48 critically ill children.
• Data collection included success rates, complication types (bleeding, venous congestion, infection), and patient factors (hypotension, coagulopathy).
• Catheters were categorized as femoral or non-femoral based on insertion site.

Main Results:

• Overall success rates were high: 91.7% for femoral and 93.8% for non-femoral catheters.
• Hypotension and coagulopathy did not significantly impact success rates.
• Minor complications like bleeding (5.5%) and venous congestion were observed with femoral catheters; infection rates were low (2.7% femoral, 6.6% non-femoral).

Conclusions:

• Percutaneous central venous catheterization in critically ill children demonstrates high success rates.
• The femoral route is a preferred site for trainees due to its low complication rate and ease of insertion.
• Central venous access via the femoral approach is a safe and effective strategy in pediatric critical care settings.