PEDIATRICS Vol. 78 No. 2 August 1986, pp. 245-250
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Prospective Evaluation of Percutaneous Central Venous Silastic Catheters in Newborn Infants With Birth Weights of 510 o 3,920 Grams

Manuel Durand MD1, Rangasamy Ramanathan MD1, Bruce Martinelli CHA/PAC1, and Milagros Tolentino RN1

1 From the Newborn Division of the Los Angeles County-University of Southern California Medical Center, and Department of Pediatrics, University of Southern California School of Medicine, Los Angeles

With improved neonatal survival, especially of very low birth weight infants, our efforts should be directed toward reduction of morbidity. Sick preterm infants require total parenteral nutrition for prolonged periods of time due to extreme prematurity and feeding intolerance. However, the use of surgically placed Broviac catheters has been associated with a high complication rate. A prospective study of 53 percutaneous central venous Silastic catheterizations for administration of total parenteral nutrition was performed in 45 newborn infants. At the time of catheter insertion, 37 babies weighed less than 1,500 g and 19 weighed less than 1,000 g. Percutaneous central venous catheters were placed successfully the first time in 50 of 55 attempts. In three babies, insertion was successful on second attempt. The catheters remained in place for 25.4 ± 16.7 days ([mean ± SD] range two to 80 days). In babies weighing less than 1,000 g, the catheters remained in place for a longer period of time (34.0 ± 18.0; range 12 to 80 days). Sixty-six percent of the catheters were removed electively. There were four cases of bacteremia (7.5%), and the overall incidence of mechanical complications was 26.4%. We conclude that percutaneous central venous catheters can be used safely and effectively in newborn infants for prolonged administration of total parenteral nutrition, especially in neonates weighing less than 1,000 g.

Key Words: percutaneous central venous catheter • Silastic catheter • newborn infant

Submitted on August 8, 1985
Accepted on October 15, 1985




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