Percutaneous subclavian central venous catheterization in children younger than one year of age

Area of Science:

• Pediatric Surgery
• Vascular Access
• Neonatal Care

Background:

• Infants under one year often need central venous lines (CVLs) for critical treatments like parenteral nutrition, antibiotics, and chemotherapy.
• Historically, surgical cut-down was preferred for central venous access in this age group.
• Percutaneous techniques offer a less invasive alternative.

Purpose of the Study:

• To evaluate the safety and success rate of percutaneous central venous access in infants under one year of age.
• To compare outcomes in infants younger than 6 months versus those older than 6 months.
• To document the Seldinger technique for subclavian vein access in this population.

Main Methods:

• Retrospective chart review of patients under one year requiring CVLs from January 1, 1999, to December 31, 1999.
• Data collected included age, diagnosis, number of CVLs, placement site, success rate, and weight.
• Percutaneous subclavian vein access was performed using the Seldinger technique.

Main Results:

• A total of 110 central venous lines were placed in 84 infants under one year.
• Success rate for percutaneous subclavian vein access was 78.8% in infants <6 months (average weight 3.1 kg).
• Success rate was 96% in infants >6 months (average weight 7.63 kg), with no reported complications.

Conclusions:

• Percutaneous central venous line placement is a safe and effective method for infants under one year.
• The Seldinger technique provides a high success rate, particularly in older infants (>6 months).
• This approach minimizes complications and is a viable alternative to surgical cut-down.