Central venous catheterisation in very low birthweight infants

Forty two premature babies (mean birth weight 980 g, mean gestation 27.6 weeks) had central venous lines inserted at a mean age of 10 days through the internal jugular vein because of poor peripheral venous access and for purposes of parenteral feeding and minimal handling. Eight babies died from complications of prematurity and four from septicaemia with a central line in situ, but the other 30 babies had lines in place for a mean of 20 days. A mean weight gain of 17.5 g/kg/day was recorded. Eight babies showed signs of infection at a mean of 22 days after insertion of the line. The other complications were thrombosis related to the catheter (three cases), embolisation (two), and hydrocephalus related to superior vena caval thrombosis (one). The policy of management is outlined, and the risks and benefits of the technique are analysed.