Central Venous Catheter Insertion for Vascular Access: A 6-year Single-center Experience

Abstract

Background: Central venous catheterization is performed for such reasons as hemodynamic monitoring, parenteral nutrition, drug and fluid administration, and extracorporeal treatment. This study aimed to retrospectively review the indications for central venous catheter (CVC) insertion for vascular access and removal by pediatric intensive care unit (PICU) physicians, catheter types, and catheter-associated complications. Materials and methods: The indications for CVC insertion and removal, catheter insertion site, types of catheters, catheter-associated complications, whether or not insertion was ultrasonographically guided, catheter-associated infections, and duration of use of 1200 catheters used by PICU physicians between 2015 and 2020 were retrospectively reviewed. Results: In all, 315 (26.3%) hemodialysis catheters and 885 (73.8%) CVCs were inserted. Mean duration of catheter use was 12.33 ± 7.28 days. CVCs were inserted most commonly (28.4% [n = 341]) based on the indication of multiple drug infusions. In total, 44.8% of the CVCs were inserted under ultrasonographic guidance. The most common reason for the removal of catheters was that they were no longer needed (76.8% [n = 921]). Catheter-associated bloodstream infection occurred at the rate of 5.5 days per 1000 catheter days. Conclusion: Central venous catheterization is becoming more widespread because of the benefits it provides during the follow-up and treatment of children. As central venous catheterization is a more invasive procedure than peripheral localization and is associated with severe complications, especially in pediatric patients, it should be carefully performed under sterile conditions and by experienced personnel based on appropriate indications. Central venous catheters should be removed as soon as the need disappears.