Long-term hyperalimentation in children through saphenous central venous catheterization

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.