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Evaluation of a Percutaneously Placed 27‐Gauge Central Venous Catheter in Neonates Weighing <1200 Grams
Author(s) -
Nakamura Kenneth T.,
Sato Yutaka,
Erenberg Allen
Publication year - 1990
Publication title -
journal of parenteral and enteral nutrition
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.935
H-Index - 98
eISSN - 1941-2444
pISSN - 0148-6071
DOI - 10.1177/0148607190014003295
Subject(s) - medicine , catheter , parenteral nutrition , percutaneous , gestational age , thrombosis , birth weight , central venous catheter , surgery , venous thrombosis , anesthesia , pregnancy , genetics , biology
A percutaneous 27‐gauge OD central venous catheter was inserted at 4 ± 3 (SD) days of age and left in place for up to 2 weeks in 20 neonates with birth weights <1200 g and >24 h of age. Parenteral nutritional solutions and medications were administered through these catheters. Twenty neonates matched for birth weight and gestational age served as paired controls. In vitro studies demonstrate that the maximum infusion rate for parenteral nutrition solutions is about 20 ml/hr. Packed red blood cells could not be infused through these catheters. In vivo results demonstrate a significant (p < 0.05) reduction in number of peripheral iv catheters inserted during study (2 ± 1 us 7 ± 4, SD) with no difference in cost per day of iv access ($79.42 ± 113.51 vs $43.91 ± 15.99. SD). Two‐dimensional ultrasound assessment of catheter thrombosis was unsuccessful. Moreover, there was no correlation between angiographic and electron microscopic evaluation of catheter tip thrombosis. Electron microscopy of catheter tips revealed 33% with complete, partial and no occlusion, respectively, and 39% with sheath thrombosis. In summary, percutaneous insertion of a 27‐gauge OD Vialon central venous catheter is a feasible alternative in providing venous access in very low birth weight infants. (Journal of Parenteral and Enteral Nutritiun 14:295–299, 1990)