Skip to main content
SpringerLink
Log in

Vascular Access in Children

  • Review/State of the Art
  • Published:
CardioVascular and Interventional Radiology Aims and scope Submit manuscript

Abstract

Establishment of stable vascular access is one of the essential and most challenging procedures in a pediatric hospital. Many clinical specialties provide vascular service in a pediatric hospital. At the top of the “expert procedural pyramid” is the pediatric interventional radiologist, who is best suited and trained to deliver this service. Growing awareness regarding the safety and high success rate of vascular access using image guidance has led to increased demand from clinicians to provide around-the-clock vascular access service by pediatric interventional radiologists. Hence, the success of a vascular access program, with the pediatric interventional radiologist as the key provider, is challenging, and a coordinated multidisciplinary team effort is essential for success. However, there are few dedicated pediatric interventional radiologists across the globe, and also only a couple of training programs exist for pediatric interventions. This article gives an overview of the technical aspects of pediatric vascular access and provides useful tips for obtaining vascular access in children safely and successfully using image guidance.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7
Fig. 8
Fig. 9
Fig. 10
Fig. 11
Fig. 12
Fig. 13
Fig. 14
Fig. 15

Similar content being viewed by others

References

  1. Gann M Jr, Sardi A (2003) Improved results using ultrasound guidance for central venous access. Am Surg 69:1104–1107

    PubMed  Google Scholar 

  2. Donaldson J (2006) Pediatric vascular access. Pediatr Radiol 36:386–397

    Article  PubMed  Google Scholar 

  3. Basford TJ, Poenaru D, Silva M (2003) Comparison of delayed complications of central venous catheters placed surgically or radiologically in pediatric oncology patients. J Pediatr Surg 38:788–792

    Article  PubMed  Google Scholar 

  4. Jaques PF, Mauro MA, Keefe B (1992) US guidance for vascular access. Technical note. J Vasc Interv Radiol 3:427–430

    Article  CAS  PubMed  Google Scholar 

  5. Donaldson JS, Morello FP, Junewick JJ et al (1995) Peripherally inserted central venous catheters: US-guided vascular access in pediatric patients. Radiology 197:542–544

    CAS  PubMed  Google Scholar 

  6. Pronovost P (2008) Interventions to decrease catheter-related bloodstream infections in the ICU: The Keystone Intensive Care Unit Project. Am J Infect Control 36(Suppl):S171.e1–S175

    Google Scholar 

  7. Tsai MH, Lien R, Wang JW, Huang HR, Chiang CC, Chu SM et al (2009) Complication rates with central venous catheters inserted at femoral and non-femoral sites in very low birth weight infants. Pediatr Infect Dis J 28:966–970

    Article  PubMed  Google Scholar 

  8. Trottier SJ, Veremakis C, O’Brien J, Auer AI (1995) Femoral deep vein thrombosis associated with central venous catheterization: results from a prospective, randomized trial. Crit Care Med 23:52–59

    Article  CAS  PubMed  Google Scholar 

  9. Murai DT (2002) Are femoral Broviac catheters effective and safe? A prospective comparison of femoral and jugular venous Broviac catheters in newborn infants. Chest 121:1527–1530

    Article  PubMed  Google Scholar 

  10. Blaivas M, Adhikari S (2009) An unseen danger: Frequency of posterior vessel wall penetration by needles during attempts to place internal jugular vein central catheters using ultrasound guidance. Crit Care Med 37:2345–2349

    Article  PubMed  Google Scholar 

  11. Alomari A, Falk A (2006) Median nerve bisection: a morbid complication of a peripherally inserted central catheter. J Vasc Access 7:129–131

    CAS  PubMed  Google Scholar 

  12. Baskin KM, Jimenez RM, Cahill AM, Jawad AF, Towbin RB (2008) Cavoatrial junction and central venous anatomy: implications for central venous access tip position. J Vasc Interv Radiol 19:359–365

    Article  PubMed  Google Scholar 

  13. Crowley JJ, Pereira JK, Harris LS et al (1997) Peripherally inserted central catheters: experience in 523 children. Radiology 204:617–621

    CAS  PubMed  Google Scholar 

  14. Chait PG, Ingram J, Phillips-Gordon C et al (1995) Peripherally inserted central catheters in children. Radiology 197:775–778

    CAS  PubMed  Google Scholar 

  15. Dubois J, Garel L, Tapiero B et al (1997) Peripherally inserted central catheters in infants and children. Radiology 204:622–626

    CAS  PubMed  Google Scholar 

  16. Abdullah BJ, Mohammad N, Sangkar JV, Abd Aziz YF, Gan GG, Goh KY et al (2005) Incidence of upper limb venous thrombosis associated with peripherally inserted central catheters (PICC). Br J Radiol 78:596–600

    Article  CAS  PubMed  Google Scholar 

  17. Janik JE, Conlon SJ, Janik JS (2004) Percutaneous central access in patients younger than 5 years: size does matter. J Pediatr Surg 39:1252–1256

    Article  PubMed  Google Scholar 

  18. Pippus KG, Giacomantonio JM, Gillis DA, Rees EP (1994) Thrombotic complications of saphenous central venous lines. J Pediatr Surg 29:1218–1219

    Article  CAS  PubMed  Google Scholar 

  19. Morello FP, Donaldson JS, Saker MC et al (1999) Air embolism during tunneled central catheter placement performed without general anesthesia in children: a potentially serious complication. J Vasc Interv Radiol 10:781–784

    Article  CAS  PubMed  Google Scholar 

  20. Kairaitis LK, Gottlieb T (1999) Outcome and complications of temporary haemodialysis catheters. Nephrol Dial Transplant 14:1710–1714

    Article  CAS  PubMed  Google Scholar 

  21. Lorenz JM, Funaki B, Van Ha T et al (2001) Radiologic placement of implantable chest ports in pediatric patients. Am J Radiol 176:991–994

    CAS  Google Scholar 

  22. Marcy PY, Magné N, Castadot P, Italiano A, Amoretti N, Bailet C et al (2007) Is radiologic placement of an arm port mandatory in oncology patients? Analysis of a large bi-institutional experience. Cancer 110:2331–2338

    Article  PubMed  Google Scholar 

  23. Saleh HM, Abdelaziz AS, Hefnawy E, Mansour O (2008) Alternate routes for children with difficult central venous access. Acta Chir Belg 108:563–568

    CAS  PubMed  Google Scholar 

  24. Tannuri U, Tannuri AC, Maksoud JG (2005) The second and third right posterior intercostal veins: an alternate route for central venous access with an implantable port in children. J Pediatr Surg 40:e27–e30

    Article  PubMed  Google Scholar 

  25. Mortell A, Said H, Doodnath R, Walsh K, Corbally M (2008) Transhepatic central venous catheter for long-term access in paediatric patients. J Pediatr Surg 43:344–347

    Article  PubMed  Google Scholar 

  26. Azizkhan RG, Taylor LA, Jaques PF, Mauro MA, Lacey SR (1992) Percutaneous translumbar and transhepatic inferior vena caval catheters for prolonged vascular access in children. J Pediatr Surg 27:165–169

    Article  CAS  PubMed  Google Scholar 

  27. Dillon PA, Foglia RP (2006) Complications associated with an implantable vascular access device. J Pediatr Surg 41:1582–1587

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Radiology, Children’s Hospital of Philadelphia, Philadelphia, PA, 19104, USA

    Ganesh Krishnamurthy & Marc S. Keller

Authors
  1. Ganesh Krishnamurthy
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Marc S. Keller
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Ganesh Krishnamurthy.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Krishnamurthy, G., Keller, M.S. Vascular Access in Children. Cardiovasc Intervent Radiol 34, 14–24 (2011). https://doi.org/10.1007/s00270-010-9865-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00270-010-9865-3

Keywords

Search

Navigation