Lower Extremity Vascular Access in Neonates and Infants: A Single Institutional Experience

Authors

Marian Gaballah, Department of Radiology, Children's Hospital of Philadelphia, 3401 Civic Center Boulevard, Philadelphia, PA 19104. Electronic address: gaballahm@email.chop.edu.
Ganesh Krishnamurthy, Department of Radiology, Children's Hospital of Philadelphia, 3401 Civic Center Boulevard, Philadelphia, PA 19104.
Jeffrey I. Berman, Department of Radiology, Children's Hospital of Philadelphia, 3401 Civic Center Boulevard, Philadelphia, PA 19104.
J Christopher Edgar, Department of Radiology, Children's Hospital of Philadelphia, 3401 Civic Center Boulevard, Philadelphia, PA 19104.
Melkamu Adeb, Department of Radiology, Yale New Haven Health, Bridgeport Hospital, Bridgeport, Connecticut.
Marc S. Keller, Department of Radiology, Children's Hospital of Philadelphia, 3401 Civic Center Boulevard, Philadelphia, PA 19104.
Adeka McIntosh, Department of Radiology, Children's Hospital of Philadelphia, 3401 Civic Center Boulevard, Philadelphia, PA 19104.
Maricarmen Nazario, Department of Radiology, Children's Hospital of Philadelphia, 3401 Civic Center Boulevard, Philadelphia, PA 19104.
Anne Marie Cahill, Department of Radiology, Children's Hospital of Philadelphia, 3401 Civic Center Boulevard, Philadelphia, PA 19104.

Document Type

Article

Publication Title

Journal of vascular and interventional radiology : JVIR

Abstract

PURPOSE: To demonstrate feasibility and evaluate outcomes of direct-stick saphenous and single-incision tunneled femoral noncuffed central venous catheters (CVCs) placed in a large series of neonates and infants at a single institution. MATERIALS AND METHODS: A retrospective review was performed for all neonates and infants receiving a lower extremity CVC by interventional radiology between 2007 and 2012. Technical success, mechanical and infectious complications, and catheter outcomes were recorded. RESULTS: There were 271 primary insertions performed in 243 children by interventional radiologists in the interventional radiology suite or at the bedside. CVCs were placed via the femoral vein with single-incision technique (84.9%) or the saphenous vein via a direct-stick technique (15.1%), with a technical success rate of 100%. The total number of catheter-days was 7,917 days (median, 19 d; range, 0-220 d). The number of primary catheter-days was 5,333 days (median, 15 d; range, 0-123.0 d), and salvage procedures prolonged catheter life by 2,584 days (median, 15 d; range, 1.0-101.0 d). The mechanical and adjusted infectious complication rates were 1.67 and 0.44 per 100 catheter-days. CONCLUSIONS: Image-guided placement of saphenous or tunneled femoral catheters using a single incision is a safe and feasible method for vascular access in neonates and infants.

First Page

1660

Last Page

8

DOI

10.1016/j.jvir.2015.08.004

Publication Date

11-1-2015

Recommended Citation

Gaballah, Marian; Krishnamurthy, Ganesh; Berman, Jeffrey I.; Edgar, J Christopher; Adeb, Melkamu; Keller, Marc S.; McIntosh, Adeka; Nazario, Maricarmen; and Cahill, Anne Marie, "Lower Extremity Vascular Access in Neonates and Infants: A Single Institutional Experience" (2015). All Research. 285.
https://scholar.bridgeporthospital.org/all_research/285

Identifier

26505937 (pubmed); 10.1016/j.jvir.2015.08.004 (doi); S1051-0443(15)00759-9 (pii)