Page 1
= Abstract =
A Safe Method of Central Venous Catheterization by Peripheral Venous Cutdown in Infants
Seok Joo Han, M.D., Seung Hoon Choi, M.D., Eui Ho Hwang, M.D.
Division of Pediatric Surgery, Department of Surgery, Yonsei University College of Medicine
Seoul, Korea
Percutaneous infraclavicular subclavian catheterization has been widely used for a total parenteral nutrition, hemodynamic monitoring and for venous access in difficult clinical situations. Many authors have claimed the infraclavicular cannulation of the subclavian vein in the tiniest infants can be performed with safety and ease, but there are always possibility of serious complications in this method.
We present our experiences of peripheral venous cutdown with Broviac catheter. Author routinely introduced Broviac catheter into central vein via peripheral venous cutdown. There was no life threatening complications and no catheter related death. The complication rate was very low. The catheter related sepsis was documented in only two patient(4.7%). The average catheter longivity was 19.59 days. In view of the safety and low rate of complication, we think that peripheral venous cutdown with Broviac catheter should be the method of choice when central venous access is neccesary in infants. The infraclavicular subclavian catheterization should be reserved in infants with few accessable peripheral vein.
Index Words:Central venous catheterization, Broviac catheter, Peripheral venous cutdown
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Page 3
Table 1. Body Weight of Patients
Body Weight(I<g)
1.0-1.5
1.5-2.0
2.0-2.5
2.5-3 .0
3.0( - )
Total
Patien Ls
4
1
4
8
8
25
---
------/-1/'-
Table 2. Distribution of Diseses
Medical
NEC
Diseases
LBW /Premature
Chronic diarrhea
Surgical
Gastroschisis
TEF
Small bowel atresia
Others *
PatienLs
8(32%)
4
3
17(68 % )
6
4
3
4 ----------------* : biliary atresia; 1, bladder ex trophy ; 1, terato
ma ; 1, barium peritonitis; 1
NEC : Necrotizing enterocolitis,
LBW : Lower birth weight
TEF : Tracheoesophageal fistula
Table 3. Used Veins
Site of Insertion
Basilic vein
Int/Ext.
jugular vein
Cephalic vein
Saphoneous vein
Subclavian vein
Total
Table 4. Complications
Complications
Catheter sepsis
Leakage
Malfunction
(occlusion)
Accidental
Removal
Total
Cases
33(79% )
5(12%)
2( 5%)
l( 2%)
l( 2%)
42
Cases
2
4
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Page 4
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q.
1. Morgan WW, Harkins G A : Percutaneous
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Page 7
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catastrophic gastrointestinal anomalies. J
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JPEN 5 : 32, 1981
