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Central venous catheters. Technique and experience at Red Cross War Memorial Children's Hospital, Cape Town,
R A Brown1, A J Millar, J Knobel
1Department of Paediatric Surgery, University of Cape Town.
Insights
Central venous catheters provide significant benefits for children needing prolonged intravenous access. Meticulous care and proper insertion ensure a low complication rate, making them safe for long-term use, especially for parenteral nutrition.
Area of Science:
- Pediatric Medicine
- Vascular Access Devices
- Medical Engineering
Background:
- Prolonged intravenous access is crucial for pediatric patients.
- Central venous catheters (CVCs) offer a solution for long-term access.
- Minimizing morbidity associated with CVCs is essential for widespread clinical adoption.
Purpose of the Study:
- To evaluate the safety and efficacy of CVCs in pediatric patients.
- To assess the complication rates associated with CVC use in children.
- To determine if CVCs can be used safely for long-term intravenous access, including parenteral nutrition.
Main Methods:
- A retrospective review of 44 CVCs in 31 pediatric patients.
- Data collected over a 40-month period, totaling 3318 catheter days.
- Analysis of complication rates including catheter sepsis, thrombosis, and technical issues.
Main Results:
- A low rate of catheter sepsis (0.3 per 100 catheter days).
- One case of catheter-related thrombosis.
- 17 technical problems were noted, with 6 requiring catheter removal.
- Overall complication rates were deemed acceptable.
Conclusions:
- Central venous catheters are beneficial for pediatric patients requiring long-term intravenous access.
- Correct insertion techniques and meticulous patient care are critical for minimizing complications.
- CVCs are a safe and advantageous option for pediatric parenteral nutrition and other long-term intravenous needs.
Abstract:
Central venous catheters can be of major benefit to children in whom prolonged intravenous access is required. For their everyday use, however, the known associated morbidity needs to be at an acceptably low level. Experience with 44 central venous catheters in 31 children (3318 catheter days over a 40-month period) is reported. The complication rate of catheter sepsis (0.3/100 catheter days), thrombosis (1 catheter), and technical problems (17, of which 6 required removal) justified catheter usage. Provided catheters are correctly inserted and the patients meticulously nursed, these catheters offer major advantages to infants and children requiring long-term intravenous access, particularly for parenteral nutrition.
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