Transthoracic intracardiac lines-A double edged sword

Area of Science:

• Pediatric Cardiac Surgery
• Vascular Access
• Intensive Care Medicine

Background:

• Central venous access is crucial for pediatric cardiac surgery patients requiring pressure monitoring and inotropic support.
• Traditional central venous lines (non-ICLs) are commonly used but may necessitate multiple insertions.
• Evaluating alternative access methods is essential for improving patient care in this population.

Purpose of the Study:

• To assess the efficiency and safety of routine transthoracic intracardiac line (ICL) use in pediatric cardiac surgery.
• To compare outcomes of ICLs with traditional central venous lines (non-ICLs).

Main Methods:

• Retrospective chart review of 376 pediatric cardiac surgery patients (198 ICL, 178 non-ICL).
• Case-control matching was employed for comparison between ICL and non-ICL groups.
• Analysis included patient characteristics, diagnoses, operative, and intensive care data.

Main Results:

• ICL duration averaged 12.87 ± 10.82 days, longer than umbilical and non-ICL durations.
• The non-ICL group required significantly more multiple line insertions (˃2) (RR 3.24).
• No significant differences in infection rates or line complications were observed between ICL and non-ICL groups.

Conclusions:

• Intracardiac lines (ICLs) are safe for infants undergoing cardiac surgery.
• ICLs can be maintained for extended periods with low complication and infection rates.
• Routine ICL use decreases the number of central venous catheter placements in pediatric cardiac surgery patients.