Venous Access for Hemodialysis in Children: Right Atrial Cannulation
During the past decade an increasing number of infants and young children have been accepted for hemodialysis and renal transplantation. In 1976 Mauer and Lynch1 reported hemodialysis of more than 150 infants and children. Until recently vascular access for children weighing less than 10 kg often required placement of an antecubital or groin external arteriovenous (A-V) shunt, or groin bridge grafts.2–4 Not only did these access devices predispose to limb ischemia and local infection, but they also destroyed proximal vessels invaluable for construction of chronic access. Alternatively, these small children were placed on peritoneal dialysis. At the University of Minnesota, the silastic Hickman catheter with an internal diameter of 1.6 mm has replaced all other forms of access for temporary or even long-term dialysis vascular access of young children weighing less than 13 kg.5,6 A shorter and larger bore catheter with an internal diameter of 2 mm (the Nevins catheter) appears to be a further improvement in providing dialysis access in children weighing less than 20 kg.7
KeywordsVenous Access External Jugular Vein Subcutaneous Tunnel Exit Wound Platysma Muscle
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- 7.Nevins TE: A new Hickman catheter for hemodialysis (HD) access in children. ASAIO, 1984 ( Abstract).Google Scholar