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Chest-to-arm tunneling technique for central venous access devices in neonates
Carmen Rodriguez Perez1, Elena Pezzotti1, Francesco Maria Risso1
1Neonatal Intensive Care Unit, Children's Hospital, ASST Spedali Civili, Brescia, Italy.
Background:
Chest-to-arm (CTA) tunneling technique has been described recently as an alternative option to exit site of the catheter in the infraclavicular area.
Method:
We report our experience with ultrasound-guided centrally inserted central catheters (CICCs) placed using CTA tunneling in six neonates. All central venous catheters were positioned with ultrasound guidance and real-time tip location.
Results:
There were no insertion-related complications; all devices were correctly positioned at the first attempt. During the follow-up, we found no catheter-related thrombosis, infections, or catheter malfunction. No tip position-related complications. Only one case of secondary malposition was reported.
Conclusion:
In our experience, the CTA tunneling technique is reliable, safe, and feasible in the neonate even from the first hours of life, as well as for preterm newborns; it could be a valid alternative to the usual exit site.
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