Subclavian Venous Catheterization in Children

Abstract

During a 12-month period, infraclavicular subclavian catheterization, using a Seldinger technique, was attempted on 77 occasions in 54 children with a median age of 2 years (range newborn to 10 years). General anaesthesia was used in the majority of cases, and catheterization was successful in 74 cases (96%). The initial catheter tip position was satisfactory in 81% of the cases, and catheters remained in situ for a median period of 7 days (range 1-28 days). There were few complications. Providing extensive experience in subclavian venous cannulation is gained in the adult, there is in our experience no minimal age or size which should limit the use of a subclavian vein catheter.

Central venous catheter placement in children: a prospective study of complications in a Brazilian public hospital

“…The overall success rate found in the present study (100%) corroborates other published studies (59-100%), which characterize the pediatric application of the Seldinger technique as safe and with low morbidity (5.8%) [11][12][13][14][15][16][17][18][19][20]. The profile of this case series does not differ from other studies [1,16,18,21].…”

“…The majority of the procedures were undertaken with general anesthesia, in the operating room, which probably contributed to the good results obtained, as advocated in some publications [13,22]. Our study supports the idea that children present no increased risk when the procedure is performed under controlled conditions.…”

“…While some authors consider it of crucial importance [13,16,21,25], others have demonstrated no association [1,7]. The association between the need for another site of CVC placement and the incidence of complications as described by some authors [1,18] was not observed in our study.…”

“…The mean age of 4 years is similar to the majority of reports in the literature. Although age and weight were reported previously as factors associated with lower rates of success by some authors [7,13,17,19,20], these factors did not influence our global success rate. However, we observed that in children with a lower body weight a change of puncture site for CVC was statistically significant (P<0.05).…”

“…Several studies have examined the morbidity and mortality associated with central venous catheterization in children, reporting complication rates of 0.7-23% [13][14][15][16][17][18][19][20][21][22][23][24][25][26][27]. The most common complications, such as arterial puncture, hematoma and pneumothorax, varied according to the puncture site [1,24].…”