Related Experiment Video
Updated: Sep 27, 2026
Hickman Catheter Use for Long-Term Vascular Access in a Preclinical Swine Model
Published on: March 31, 2023
Medium and long term central venous access in children
1Department of Pediatric Surgery, St. John s Medical College Hospital, Bangalore, India.
Insights
Central venous access devices (CVAD) are safe and feasible for pediatric patients, including neonates and infants. While insertion complications can occur, particularly in neonates and during emergency bedside procedures, major issues were not observed.
Area of Science:
- Pediatric Medicine
- Vascular Access Devices
- Infectious Disease Control
Background:
- Central venous access devices (CVAD) are crucial for managing critically ill children.
- Standardized protocols are essential for safe CVAD insertion and management in pediatric populations.
Purpose of the Study:
- To evaluate the safety and feasibility of central venous access device (CVAD) insertion in a pediatric cohort.
- To identify risk factors for insertion-related complications and catheter-associated infections (CAI) in children.
Main Methods:
- A uniform protocol governed the insertion of 104 central venous access devices (CVAD) in 91 pediatric patients.
- Data collected included patient demographics, insertion circumstances (planned vs. emergency), complications, and catheter dwell time.
Main Results:
- Twelve minor insertion-related complications occurred, with higher risk in neonates and bedside insertions.
- Non-infectious complications occurred in 20% of cases, influenced by age and insertion site (femoral route safest).
- Catheter-associated infections (CAI) incidence was 15.4%, with neonates at higher risk; only 2 cases of catheter-associated bloodstream infection were reported.
Conclusions:
- Central venous access device (CVAD) use is feasible and safe in pediatric patients, particularly neonates and infants.
- Risk factors for complications include neonatal age and emergency bedside insertion.
- Careful consideration of age, insertion site, and potential complications can optimize catheter duration.
Abstract:
From September 2000 to August 2001, 104 central venous access devices (CVAD) were inserted in 91 children, governed by a uniform protocol. Thirty catheters were inserted in neonates, 29 in infants, 37 in children and 8 in adolescents. Fifty-one were planned insertions in the operating suite and 53 were emergencies - often by the bedside. There were 12 insertion related complications-all of which were minor. Neonatal age and bedside introduction had a higher risk of insertion related problems. The incidence of non-infectious complications was 20% (rate of 13.7/1000 line days) and was influenced by the child's age and insertion site. Femoral route was the safest. Incidence of catheter associated infections (CAI) was 15.4% (rate of 11/1000 line days). Only 2 children had catheter associated bloodstream infection. Neonates were at higher risk of catheter related infections. Age, insertion site and occurence of insertion complications influenced duration of catheterization (median 7.5 days, range 2-243 days) There was no major complication, though more than 50% insertions were in neonates and infants. In our practice, use of CVAD is feasible and safe, especially in neonates and infants.
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