Complications of central venous catheterization in critically ill children

Abstract

Analysis of central venous catheterization complications in different access sites with the Seldinger technique. A prospective study (May 1992 through December 1996) of 308 central venous catheterizations in children of different ages in a pediatric intensive care unit. Access sites were the subclavian vein (76.3%), femoral vein (20.4%), and jugular vein (3.2%). The frequency of catheter placement-related complications was 22%, and the frequency of serious catheter placement-related complications was 2.9% (pneumothorax 1.9%, hemothorax 1%). Catheter placement-related complications were more common in the subclavian than in the femoral vein (chi-square, p = .02) for the larger bore catheters (chi-square, p = .01) and for the higher number of attempts (Student’s t-test, p t Central venous catheterization can be performed readily in children of all ages with an acceptable degree of risk. The immediate complications were more frequent and severe for subclavian vein catheterization, and the highest risk factor was the number of attempts at catheter insertion. Although the most frequent late complications were mechanical, which were higher for the femoral access and long-indwelling catheters, femoral catheters can be left indwelling for longer periods if routine ultrasound follow-up is performed. Infectious complications were independent of the venous access site or the duration of catheterization.