Subclavian vein catheterization in critically ill children: Analysis of 322 cannulations

Abstract

Complications in 322 percutaneous subclavian vein catheters placed in 272 children by the infraclavicular approach were investigated prospectively. Ages ranged from 4 days to 15 years. Incidents during catheter introduction occurred in 13 cases, and were more common when insertion was on the right side (p less than 0.01). Nine (2.8%) required urgent treatment: (6 pneumothorax, 1 hydrothorax, and 2 hemothorax). Anomalous lodging of the catheter tip was more common when insertion was on the right side (p less than 0.05). Complications during catheter maintenance were 3 venous thromboses, 3 catheter obstructions, and 7 migrations out of position. There was no significant difference in complications related to age. Catheter cultures were positive in 33 (17%) of 190 catheters cultured (27 through colonization and 6 through catheter-related sepsis). Staph. epidermidis was the organism most frequently isolated (19 cases; 58%). Catheterization time of more than 5 days and catheter-related sepsis were statistically associated (p less than 0.05). Staph. epidermidis isolation and duration of cannula use were statistically related (p less than 0.01). No catheter-related deaths occurred. We conclude that subclavian vein catheterization is a simple and useful procedure that entails relatively few serious complications when performed by experienced pediatricians.

Risk factors for healthcare-associated infection in pediatric intensive care units: a systematic review

“…Abstracts for which there was no agreement as to the inclusion were analyzed jointly and the decision was made by consensus. Thus, 84 (80 articles and four theses) were ob-tained for detailed reading by the same two authors independently 27,28,29,30,31,32,33,34,35,36,37,38,39,40,41,42,43,44,45,46,47,48,49,50,51,52,53,54,55,56,57,58,59,60,61,62,63,64,65,66,67,68,69,70,71,72,73,74,75,76,77,…”

A potentially fatal complication during subclavian vein catheterization in an infant with congenital heart disease—puncture to pulmonary artery directly: a case report

“…We found that SVC has a few advantages. For example, SVC has a lower risk of infection than femoral venous catheterization [6]. It is also less difficult than internal jugular vein (IJV) catheterization to perform in infants with short necks and larger-than-usual head-to-body proportions [1,3].…”

Punção percutênea da veia subclávia em crianças e adolescentes: sucesso, complicações e fatores associados

“…3,4,9,10,12,13,16 Performing the procedure with the patient sedated resulted in greater success rates than carrying out catheterization with the patient conscious. We believe that rendering the patient immobile facilitates the identification of anatomical points and prevents the needle from becoming displaced from the vein during introduction of the catheter, increasing the success rate.…”

“…1,9,10,18,19 Pneumothorax is a complication that can put patient's art risk of death, and its incidence in the literature varies from 0.2 to 2.4%. 1,9,10,18,19 In our study, this complication 12,20 It is possible that this parameter for defining experience should be reassessed, although it has not been adopted as a rule.…”

“…4 Although the literature considers this to be a safe procedure in children, it is subject to complications, such as pneumothorax, hemothorax, arterial puncture, arrhythmia, ill-positioned catheters and infection. 1,3,[8][9][10] In the literature consulted, complication rates varied from 0.7 to 30%, 2,[11][12][13] with only a small proportion of these endangering the lives of patients; however, these complications can increase the length and cost of hospital stays.…”