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Minimizing complications associated with percutaneous central venous catheter placement in children: recent advances

John M Costello1, Timothy C Clapper, David Wypij

  • 1Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA. jmcostello@luriechildrens.org

Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies
|February 9, 2013
PubMed

Insights

Complications from central venous catheters in critically ill children are common. Strategies like ultrasound guidance and infection bundles are improving outcomes, though more research is needed for thrombosis prevention.

Area of Science:

  • Pediatric Critical Care Medicine
  • Vascular Access Devices
  • Medical Device Complications

Background:

  • Central venous catheters are vital in pediatric critical care but associated with significant complications.
  • Understanding the prevalence and nature of these complications is crucial for patient safety.
  • Existing knowledge on complication rates and prevention strategies requires synthesis.

Purpose of the Study:

  • To summarize current knowledge on central venous catheter complications in critically ill children.
  • To review and highlight evolving strategies for minimizing these complications.
  • To identify areas where further research is needed.

Main Methods:

  • Comprehensive literature review of PubMed and EBSCOhost databases.
  • Keywords included: central venous catheter, children, ultrasound, infection, thrombosis, thromboembolism.
  • Focus on pediatric literature, prioritizing randomized clinical trials and prospective studies.

Main Results:

  • Complications are frequent in pediatric central venous catheter placement, potentially linked to vascular anatomy.
  • Thrombosis is an emerging concern with limited evidence-based preventive measures.
  • Catheter-associated bloodstream infection rates have declined due to enhanced education and care bundles.

Conclusions:

  • Central venous catheter complications in children are prevalent and multifactorial.
  • Improved infection control measures have successfully reduced bloodstream infections.
  • Ultrasound guidance shows promise for catheter placement, but further investigation is warranted, especially for thrombosis.
  • Evidence-based strategies for preventing thrombosis require development.
Abstract

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