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Survey of the use of peripherally inserted central venous catheters in neonates with critical congenital cardiac disease

Published online by Cambridge University Press:  26 February 2007

Lin-Hua Tan ,
Beth Hess ,
Laura K. Diaz ,
Christopher I. Cassady ,
Zhuo Ming Xu ,
Luca Di Chiara ,
Charles D. Fraser ,
Dean Andropoulos ,
Anthony C. Chang  and
F. Glen Seidel
Lin-Hua Tan
Affiliation:
Department of Surgical Intensive Care Unit, Children's Hospital, Zhejiang University College of Medicine, Hangzhou, Zhejiang, China
Beth Hess
Affiliation:
Department of Cardiology and Cardiac Intensive Care Unit, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas, United States of America
Laura K. Diaz
Affiliation:
Department of Pediatric Cardiovascular Anesthesiology, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas, United States of America
Christopher I. Cassady
Affiliation:
Department of Interventional Radiology, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas, United States of America
Zhuo Ming Xu
Affiliation:
Department of Pediatric Thoracic and Cardiovascular Surgery, Shanghai Children's Medical Center, Shanghai Second Medical University, Shanghai, China
Luca Di Chiara
Affiliation:
Department of Pediatric Anesthesiology, Bambino Gesu Children's Hospital, Rome, Italy
Charles D. Fraser
Affiliation:
Department of Congenital Heart Surgery, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas, United States of America
Dean Andropoulos
Affiliation:
Department of Pediatric Cardiovascular Anesthesiology, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas, United States of America
Anthony C. Chang
Affiliation:
Department of Cardiology and Cardiac Intensive Care Unit, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas, United States of America
F. Glen Seidel
Affiliation:
Department of Interventional Radiology, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas, United States of America
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Abstract

Neonates with congenital cardiac disease are a special population. They are often critically ill, and need prolonged intravenous access. To date, no study has evaluated the efficacy and safety of peripherally inserted central venous catheters placed in this unique population. Our goal was to evaluate the use of such catheters in neonates with critical congenital cardiac disease, and to study features such as duration of use, reasons for removal of catheters, and complications. We inserted a total of 124 catheters in 115 neonates with critical congenital cardiac disease who were admitted to the Intensive Care Unit at Texas Children's Hospital from August 2002 to August 2004. The patients had a mean age of 10 days, and a mean weight of 3.1 kilograms. The peripherally inserted catheters were in place for a mean of 22.3 days. Therapy was completed in 76.6% patients at the time of removal of the catheter. The incidence of occlusion, dislodgement, and thrombus was 4.0%, 2.4%, and 1.6%, respectively. The infection rate was 3.6 per 1000 catheter-days, with a median onset on 37 days after placement. We conclude that central venous catheters, when inserted peripherally, provide reliable and safe access for prolonged intravenous therapy in neonates with critical congenital cardiac disease.

Keywords

Complicationcatheter-related infectionthrombuscentral venous access
Type
Original Article
Information
Cardiology in the Young , Volume 17 , Issue 2 , April 2007 , pp. 196 - 201
Copyright
© 2007 Cambridge University Press

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