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Long-term hyperalimentation in children through saphenous central venous catheterization
Insights
Central venous catheters inserted via the saphenous vein in children offer a safe and effective method for parenteral nutrition. This approach demonstrated a low complication rate, making it an optimal choice for pediatric fluid administration.
Area of Science:
- Pediatric Surgery
- Vascular Access
- Gastroenterology
Background:
- Central venous catheters are crucial for long-term fluid and nutritional support in pediatric patients.
- Traditional venous access sites in children can present challenges regarding insertion and complication rates.
- The saphenous vein offers a potential alternative route for central venous access in pediatric populations.
Purpose of the Study:
- To evaluate the safety and efficacy of inserting Silastic central venous catheters into the inferior vena cava via the saphenous vein in children.
- To assess the complication rates and management simplicity of this specific venous access technique.
- To determine if this method is an optimal site for parenteral nutrition in pediatric patients.
Main Methods:
- A retrospective review of 151 Silastic central venous catheter insertions over 3.5 years in 132 children (<19 years) at UCLA Hospital.
- Catheters were inserted into the inferior vena cava through the saphenous vein.
- Data collected included indications for use, duration of catheterization, and complication rates.
Main Results:
- 151 catheters were used for 13,288 days (mean 88 days per catheter).
- Major indications included inflammatory bowel disease, cancer/bone marrow transplantation, and short bowel syndrome.
- Complications requiring removal occurred in 31 patients (1 per 225 days of use), with no catheter-related deaths.
Conclusions:
- Central venous catheterization via the saphenous vein in children is associated with a low complication rate.
- This technique is simpler to manage and has fewer complications compared to other venous sites in young children.
- Saphenous vein access to the vena cava is an optimal site for parenteral nutrition in infants and children.
Abstract:
During a 3.5 year period, 151 Silastic central venous catheters were inserted into the inferior vena cava through the saphenous vein in 132 children younger than age 19 years at UCLA Hospital. The major indications for catheter insertion included inflammatory bowel disease, cancer or bone marrow transplantation, and short bowel syndrome. The 151 catheters were used for a total of 13,288 days of fluid administration (mean 88 days). Complications requiring removal of the catheter occurred in 31 patients, but there were no deaths attributable to complications from the catheters. The total incidence of complications was one per 225 days of catheter use, less than that occurring in catheters placed in the external jugular and cephalic veins in young children in our hospital. The ease of insertion, the low complication rate and the simplicity of patient management when catheters are placed into the vena cava through the saphenous vein appear to make this an optimal site for administering parenteral nutrition in infants and children.