Pediatric Vascular Access in Brief: Preoperative, Operative, and Postoperative Considerations

All surgeons need to know about vascular access. Here we review some preoperative, operative, and postoperative considerations of pediatric vascular access with Dr. Alex Bondoc from Cincinnati Children’s Hospital, including indications, contraindications, work-up considerations, tips for placement, and postoperative considerations. Featuring information about locking solutions with Dr. Paul Wales.

Hosts: Rod Gerardo, Ellen Encisco, Brittany Levy

Additional information:

Chest radiograph after fluoroscopic guided line placement: No longer necessary https://www.sciencedirect.com/science/article/pii/S002234681600066X?casa_token=4yo96oGaJGAAAAAA:FDk5b0D_StNjPIr4VSqDjbJd9EfbaRVUmtDr2uwmXjFYykrcpSAr1fuBnDBNo20HBbfiArn-QmI

Ethanol lock therapy to reduce the incidence of catheter-related bloodstream infections in home parenteral nutrition patients with intestinal failure: preliminary experience https://www.sciencedirect.com/science/article/pii/S0022346811001485?casa_token=E2MO5BiFaCMAAAAA:MduHXp_k5LYTccdhe-CTlGGE6bDcQ9eMvHomeOBhhfasWnXlfDtl5kjfYfY2-IW1lmT3ViL3Ps0

Ethanol Locks to Prevent Catheter-Related Bloodstream Infections in Parenteral Nutrition: A Meta-Analysis https://publications.aap.org/pediatrics/article-abstract/129/2/318/32659/Ethanol-Locks-to-Prevent-Catheter-Related

Prevention of catheter-related blood stream infections in children with intestinal failure https://journals.lww.com/co-gastroenterology/Fulltext/2013/01000/Prevention_of_catheter_related_blood_stream.2.aspx

Reduction of Central Line–Associated Bloodstream Infections and Line Occlusions in Pediatric Intestinal Failure Patients Receiving Long‐Term Parenteral Nutrition Using an Alternative Locking Solution, 4% Tetrasodium Ethylenediaminetetraacetic Acid https://aspenjournals.onlinelibrary.wiley.com/doi/10.1002/jpen.1989

00:00 Introduction
00:56 Types of vascular access
01:53 Where to place central venous catheters
02:23 Indications for central access
02:41 Contraindications to central access
02:57 Preprocedural work-up considerations
03:53 Patient positioning
04:28 Neonatal access considerations
05:05 Imaging guidance for access
06:42 Tips for subclavian access
07:46 Tips for getting the catheter tip in the right location
09:02 Postprocedural complications
09:32 Management of line infections
10:34 Locking solutions
12:08 Additional considerations
13:26 Conclusion

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