PEDIATRICS Vol. 85 No. 4 April 1990, pp. 531-533
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Percutaneous Catheterization of the Axillary Vein in Infants and Children

Richard I. Metz MD1, Steven E. Lucking MD1, Frank C. Chaten MD1, Thomas M. Williams MD1, and John J. Mickell MD1

1 From the Department of Pediatrics, Division of Critical Care Medicine, Children's Medical Center, Medical College of Virginia, Richmond, Virginia

The axillary vein was evaluated as an alternative access site for central venous catheterization in critically ill infants and children. Children were placed in the Trendelenberg position (when possible) with arm abducted 100 to 130°. The vein was entered parallel and inferior to the artery. Success rate for catheterization was 79% (41/52). Catheter diameter range was 3 to 8.5 F and catheter length range was 5 to 30.5 cm. Median patient weight was 7.0 kg (3.0 to 59 kg). Median age was 0.91 years (14 days to 9 years). All central lines ended in the subclavian, innominate, or superior vena cava. Median catheter duration was 8 days (2 to 22 days). A total of 338 patient catheter-days were studied. Central venous pressure was successfully monitored in five of five attempts. Complications with insertion (3.8% of attempts) included one pneumothorax and one hematoma. Complications during catheter duration (9.8% of catheters, 1.1% per catheter-day) included one instance each of venous stasis, venous thrombosis, catheter sepsis, and parenteral nutrition infiltration. No complication contributed to a patient mortality. Success and complication rates were comparable with those in jugular catheterization studies in children. The axillary approach is an acceptable route for central venous catheterization in critically ill infants and children.

Key Words: axillary vein • catheterization

Submitted on January 27, 1989
Accepted on April 25, 1989




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