03:36 PM Abstract No. 47 Outcomes of tunneled internal jugular venous catheters in children younger than 3 months of age

Abstract

There is limited data on complications of central lines in younger infants. The purpose of this study is to identify factors which may affect complication rates of tunneled internal jugular (IJ) venous catheters placed in neonates and infants under 3 months of age. This is a retrospective review of patients 90 days of age and under who underwent tunneled IJ venous catheter placements in the pediatric interventional radiology department at a single institution over a 4-year period. Patient demographics, device characteristics, procedural factors, and clinical follow-up were collected for each catheter placed. Complication rates, fluoroscopy times, and procedural times were analyzed based on patient age, weight at time of placement, side of placement, and technique (single-incision or conventional). Complication types (line malfunction, malpositioning, or infection) were analyzed based on duration of placement and method of resolution. 65 lines were placed in 63 patients with a total dwell time of 2,799 line days. A total of 15 complications were observed which required either replacement over a wire or removal (total complication rate 23%). Complications included 3 line malfunctions, 8 malpositioned lines, and 4 infections. There were 7 complications (including 1 infection) that occurred within 30 days of line placement. Catheters placed using the single-incision technique (20) had a statistically significant lower rate of complications compared with conventional technique (45); (5% vs 31%, p = 0.03). Although not statistically significant, patients under 30 days of age had a higher complication rate compared to older patients (27% vs 22%), patients weighing less than 5 kg had a higher complication rate compared to heavier patients (25% vs 20%), and left IJ catheters had a longer average procedure time compared to the right (39 minutes vs 24 minutes). When caring for patients less than 3 months of age who require tunneled internal jugular venous access, a single-incision technique may lead to lower rates of complication. It is also important to be aware of factors which may lead to a higher rate of complication, such as younger age and lighter weight.