[Percutaneous or surgical central catheters in the newborn infant]

Central microcatheters are important in neonatal intestinal surgery, as peripheral veins are quickly all used up in these patients; they are essential in maintaining a satisfactory nutritional status during the period of digestive exclusion. This retrospective study over an 18 month period concerned 105 catheters (82 central percutaneous catheters and 23 surgical catheters) put up in neonates operated on within the first few days of life. The advantages and disadvantages of both methods of catheterization were assessed by means of the infectious or mechanical complications, as well as the length of time the catheters were used. The frequency, timing and type of mechanical incidents requiring removal of the catheter were the same for both groups. There was only one septic accident, and this with a surgical catheter. An analysis of the patient files helped to decide on the best route for use in central catheterization, as well as technical improvements. Because of the absence of infectious accidents in the percutaneous series, this method was preferred, especially as it has a certain number of advantages over the surgical method. Percutaneous central microcatheterization would appear well suited to medium term parenteral feeding.