Affiliations: Division of Neonatal-Perinatal Medicine, Department of
Pediatrics, School of Medicine, University of California Irvine, Irvine, CA, USA
Note: [] Corresponding author: Dr. Houchang D. Modanlou, Division of
Neonatology, University of California Irvine, 101 City Drive South, UCIMC,
Building 56, Suite 600, Orange, CA 92868, USA. E-mail: modanlou@uci.edu
Abstract: The lower extremity veins are less utilized for the insertion of
central catheter for prolonged venous access and the provision of total
parenteral nutrition. We compared the complication rates for catheters inserted
from the lower extremity veins in relation to their tip placement. During a
48-month period, 90 catheters inserted from the lower extremity veins were
identified and their tip placement was documented. Catheter tips were placed in
the upper portion of the inferior vena cava below the right atrium in 65, and
just above or below the renal veins in 25. Data was analyzed for gestational
age, birth weight, duration of catheters in place, duration of total parenteral
nutrition, complications, necrotizing enterocolitis, serum direct bilirubin,
liver enzyme, serum creatinine, length of hospitalization, and survival rate. The median birth weight and gestational age, duration of catheter in place,
duration of total parenteral nutrition infusion were similar between the two
groups. Catheter related infections, occlusions, phlebitis, and leakage;
necrotizing enterocolitis, intraventricular hemorrhage, serum direct bilirubin,
liver enzyme and serum creatinine were also similar between the two groups. We suggest that the lower extremity veins inserted catheters, with their tips at a
lower position of the inferior vena cava may be as safe as those with their
tips at the upper part of the inferior vena cava below the right atrium.
