Tunneling technique for central venous access devices in neonates
Abstract:
Background: Chest-to-arm (CTA) tunneling technique has been described recently as an alternative option to exit site of the catheter in the infraclavicular area.
Method: We report our experience with ultrasound-guided centrally inserted central catheters (CICCs) placed using CTA tunneling in six neonates. All central venous catheters were positioned with ultrasound guidance and real-time tip location.
Results: There were no insertion-related complications; all devices were correctly positioned at the first attempt. During the follow-up, we found no catheter-related thrombosis, infections, or catheter malfunction. No tip position-related complications. Only one case of secondary malposition was reported.
Conclusion: In our experience, the CTA tunneling technique is reliable, safe, and feasible in the neonate even from the first hours of life, as well as for preterm newborns; it could be a valid alternative to the usual exit site.
Reference:
Rodriguez Perez C, Pezzotti E, Risso FM. Chest-to-arm tunneling technique for central venous access devices in neonates. J Vasc Access. 2023 May 7:11297298231174064. doi: 10.1177/11297298231174064. Epub ahead of print. PMID: 37151028.