Insertion of a small central venous catheter in neonates and young infants.
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| Abstract |
Total parenteral nutrition (TPN) administered through a central venous catheter in low-birthweight neonates and infants has been complicated by mechanical catheter malfunctions and catheter-associated infections. A retrospective survey of catheter complications 66 infants with 90 pediatric Broviac (1.3 mm o.d.) and large-diameter (French size 3, 4, and 5) Silastic catheters revealed 17 mechanical malfunctions (27%) and 16 cases (26%) of catheter infections. The current study presents our experience using 58 small-diameter (0.635 mm o.d.) Silastic catheters for TPN in 53 neonates and infants. There were 13 episodes (22%) of mechanical problems such as accidental dislodgement, occlusion of the catheter, and perforation of the tubing. Only four cases (7%) of catheter-associated sepsis occurred, a significant reduction (p = 0.008) in this serious problem compared to the previous large catheter study. We have compared clinical features of both large- and small-diameter catheters and suggest specific guidelines for their use. The small-diameter Silastic catheter is safe, easily inserted, and effective in the critically ill, low-birthweight neonate and in young infants weighing less than 6 kg. The pediatric Broviac catheter is recommended for administration of long-term or home TPN to infants and children greater than 6 kg. These catheters are useful for multiple purposes such as blood drawing, chemotherapy, and nutritional support while the small catheter is not as versatile.
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| Authors | D S Loeff, M E Matlak, R E Black, J C Overall, J L Dolcourt, D G Johnson |
| Journal | Journal of pediatric surgery (J Pediatr Surg) Vol. 17 Issue 6 Pg. 944-9 (Dec 1982) ISSN: 0022-3468 [Print] United States |
| PMID | 6819354 (Publication Type: Comparative Study, Journal Article) |
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