Central Subclavian Catheterization in Newborns: Single-Center Experience

Mehmet Selcuk Bektas,Selcuk Gurel,Ahmet Gözen

doi:10.1055/s-0041-1741425

Mehmet Selcuk Bektas, Selcuk Gurel + Show 1 more

Open Access

https://doi.org/10.1055/s-0041-1741425

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Journal: Journal of Child Science	Publication Date: Jan 1, 2022
License type: CC BY 4.0

Affiliation: Lokman Hekim Üniversitesi

Abstract

AbstractOur main aim of this article was to show that central venous catheter (CVC) can be an easy-to-use, less-complicated catheter application such as peripherally inserted central catheter and umbilical catheter placement in the neonatal intensive care unit. We here described our experience with subclavian vein catheterization. Neonates who had venous access through subclavian central catheterization were assessed retrospectively. Data such as gestational age, age at the time of catheter insertion, birth weight, and gender were collected. In addition, problems related to catheterization during hospitalization were documented. This study comprised 40 newborns, 22 male and 18 female, with a mean gestational week of 29.57 ± 3.80 weeks and a mean gestational weight of 2067.50 ± 545.97 g. Due to occlusion, catheters were switched in five cases twice and in three cases once, totaling 53 catheterizations on 40 newborns. None of our patients had pneumothorax or hemothorax. On the postoperative 8th and 21st days, the catheter was withdrawn due to catheter infection in two (5%) patients, and catheter cultures revealed coagulase negative Staphylococcus aureus in both cases. Even in preterm infants, subclavian central venous catheterization is a safe and straightforward technique of gaining venous access in expert hands in the neonatal intensive care unit.

Highlights

Central venous catheters (CVCs) enable more secure venous access for a longer period of time, which is essential for whole parenteral feeding and administration of intravenous fluids and drugs to infants admitted in neonatal intensive care units (NICUs).[1,2]
When an alternate peripheral line cannot be established, umbilical venous catheters, peripherally inserted central catheters (PICCs), and central venous catheters (CVCs) are the main methods of venous access in neonates
All complications associated with subclavian central venous catheterization were recorded

Summary

Introduction

Central venous catheters (CVCs) enable more secure venous access for a longer period of time, which is essential for whole parenteral feeding and administration of intravenous fluids and drugs to infants admitted in neonatal intensive care units (NICUs).[1,2] When an alternate peripheral line cannot be established, umbilical venous catheters, peripherally inserted central catheters (PICCs), and CVCs are the main methods of venous access in neonates. CVCs have become popular, especially in premature neonates, due to their importance and ease of insertion by qualified clinicians.[3] a recent study found that preterm children with very low birth weights who had central catheters gained considerably more weight and spent less time in the hospital than those who did not.[4]. Complications such as misplacement, infections, and thrombosis can occur when a CVC is inserted in a severely ill, very small infant.[5]. They are associated with increased risk of misplacement, thrombosis, and late onset sepsis especially when they are used for more than 5 to 7 days.[6,7] Other alternatives for venous access are PICCs that have the similar infection rates especially among preterm neonates born at

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