Neonatal Vascular Access
Advances in the medical and surgical management of neonates are often predicated upon secure vascular access. Requirement for vascular access may be for physiological monitoring (arterial or central venous pressure), direct treatment (antibiotics, chemotherapy), supportive therapy (nutrition, transfusion, dialysis, ECMO), diagnostic radiological, and procedural purposes (drainage of CSF or chyle, minimally invasive cardiac interventions). It is important for the surgeon to have a broad working knowledge of this field, as, given the multidisciplinary nature of modern neonatal intensive care, the options for and scope of vascular access are expanding alongside the number of subspecialties with interests and relevant skills in this area.
KeywordsVascular access Central venous catheter Newborn surgery
- 1.Rivera AM, Strauss KW, van Zundert A, Mortier E. The history of peripheral intravenous catheters: how little plastic tubes revolutionized medicine. Acta Anaesth Belg. 2005;56:271–82.Google Scholar
- 2.Dudrick SJ, Vars HM, Rawnsley HM, Rhoads JE. Total intravenous feeding and growth in puppies. Fed Proc. 1966;25:481.Google Scholar
- 5.Shukla H, Farrara A. Rapid estimation of umbilical catheters in newborns. Am J Dis Child. 1986;140:786–8.Google Scholar
- 7.Kabra NS, Kumar M, Shah SS. Multiple versus single lumen umbilical venous catheters for newborn infants. Cochrane Database Syst Rev. 2005;(3):CD004498. https://doi.org/10.1002/14651858.CD004498.pub2.
- 13.John CM, Harkensee C. Thrombolytic agents for arterial and venous thrombosis in children. Cochrane Database Syst Rev. 2005;(1):CD004342. https://doi.org/10.1002/14651858.CD004342.pub2.
- 14.Department of Health. Review of the deaths of four babies due to cardiac tamponade associated with the presence of a central venous catheter. 24182 1p 1.7k June 2001.Google Scholar
- 17.National Institute for Clinical Excellence. Guidance on the use of ultrasound locating devices for placing central venous catheters. Technol Appraisal Guidance. 2005:49.Google Scholar
- 21.Hackbarth R, Bunchman TE, Chua AN, Somers MJ, Baum M, Symons JM, Brophy PD, Blowey D, Fortenberry JD, Chand D, Flores FX, Alexander SR, Mahan JD, McBryde KD, Benfield MR, Goldstein SL. The effect of vascular access location and size on circuit survival in pediatric continuous renal replacement therapy: a report from the PPCRRT registry. Int J Artif Organs. 2007;30:1116–21.CrossRefGoogle Scholar
- 23.Jardine LA, Inglis GDT, Davies MW. Prophylactic systemic antibiotics to reduce morbidity and mortality in neonates with central venous catheters. Cochrane Database Syst Rev. 2008;(1):CD006179. https://doi.org/10.1002/14651858.CD006179.pub2.
- 24.van de Wetering MD, van Woensel JBM. Prophylactic antibiotics for preventing early central venous catheter Gram positive infections in oncology patients. Cochrane Database Syst Rev. 2007;(1):CD003295. https://doi.org/10.1002/14651858.CD003295.pub2.
- 26.Shah P, Shah V. Continuous heparin infusion to prevent thrombosis and catheter occlusion in neonates with peripherally placed percutaneous central venous catheters. Cochrane Database Syst Rev. 2005;(3):CD002772. https://doi.org/10.1002/14651858.CD002772.pub3.
- 28.Shah PS, Shah N. Heparin-bonded catheters for prolonging the patency of central venous catheters in children. Cochrane Database Syst Rev. 2007;(4):CD005983. https://doi.org/10.1002/14651858.CD005983.pub2.
- 30.Gillies D, Carr D, Frost J, O’Riordan E, Gunning R, O’Brien I. Gauze and tape and transparent polyurethane dressings for central venous catheters. Cochrane Database Syst Rev. 2003;(4):CD003827. https://doi.org/10.1002/14651858.CD003827.
- 31.Foster J, Richards R, Showell M. Intravenous in-line filters for preventing morbidity and mortality in neonates. Cochrane Database Syst Rev. 2006;(2):CD005248. https://doi.org/10.1002/14651858.CD005248.pub2.