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Central Venous and Arterial Access for Children

  • Neil ChambersEmail author
  • Yu-Ping Chen
Chapter

Abstract

Arterial and central venous access is challenging in children due to their smaller and more mobile vessels. In addition, short and long-term damage to vessels is more likely in children due to the limited catheter sizes available for venous and arterial access. Peripherally Inserted Central Catheters (PICC) avoid children needing multiple peripheral intravenous catheters, and often facilitate treatment as an outpatient. Tunneled, cuffed central catheters (Hickman or Broviac) may last several months and are preferred for oncology treatment. Vascular access may cause thrombosis in the short term, and vessel stenosis in the longer term, which may affect subsequent access for the child. The size of the catheter relative to the size of the vein affects the likelihood of vessel damage, and in general the vein should be at least three times the diameter of the catheter. Multidisciplinary vascular access teams have evolved to develop insertion skills for a variety of catheter devices, and to have an active role in device selection, timing of insertion, and to assist with management and troubleshooting of the device. These teams can be nurse-led and they ensure the appropriate device is chosen to complete the planned duration of therapy without the need for re-insertion or replacement of the device.

Keywords

Central venous access in children Ultrasound for arterial catheters Pediatric central venous access devices Broviac catheter Pediatric infusaport 

Further Reading

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Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  1. 1.Department of Anaesthesia and Pain ManagementPerth Children’s HospitalNedlandsAustralia

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