PERIPHERALLY INSERTED CENTRAL CATHETERS IN INFANTS AND CHILDREN

PURPOSE: To determine prospectively the feasibility, complications, an d mid-and long-term advantages of peripheral insertion of central cath eters in infants and children. MATERIALS AND METHODS: During a 15-mont h period between March 1995 and June 1996, a total of 285 catheter pla cement attempts were made to peripherally insert central catheters in 183 pediatric patients (89 boys, 94 girls). Phlebographic guidance was used, and the catheters were inserted below the elbow in 99% of cases . Catheter insertion was indicated for prolonged antibiotic therapy in 108 patients (158 catheter placement attempts), hematologic or oncolo gic care in 24 patients (40 attempts), total parenteral nutrition in 1 6 patients (46 attempts), and venous access for fluid or blood in 35 p atients (41 attempts). The success rate and complications were recorde d along with the indication, patient age, and duration of catheter pla cement. RESULTS: One hundred fifty-two of 158 (96%) catheter placement attempts were successful in outpatients (n = 108), 124 of 127 (98%) i n hospitalized patients (n = 75), and 70 of 73 (96%) in patients aged less than 1 year. Infection and pericatheter venous thrombosis were th e main complications and were seen in 17 of 276 (6%) and one of 276 (0 .3%) catheter placement attempts, respectively. Catheter occlusion occ urred in 23 of 276 (8%) catheter placement attempts. CONCLUSION: Perip heral insertion of central catheters was highly feasible in infants an d children with this protocol. Such catheters were well tolerated in t he pediatric population with a low frequency of complications.