Central parenteral alimentation in newborn infants: a new technique for catheter placement
Vain, N.E.; Georgeson, K.E.; Cha, C.C.; Swarner, O.W.
Journal of Pediatrics 93(5): 864-866
1978
ISSN/ISBN: 0022-3476 PMID: 101648 Document Number: 138026
Parenteral nutrition is frequently used for premature infants as a supplement to milk feedings. Many neonatologists have suggested total parenteral nutrition as the 1st choice for very low-birth-weight premature infants. This is the only possible source of nutrients for infants with poor feeding tolerance, necrotizing enterocolitis, or congenital malformations of the gastrointestinal tract requiring major surgery. Because of the well-known complications of TPN provided through central catheters, this method is used only when adequate nutrition by peripheral i.v. cannot be maintained. A new technique for catheter placement which appears to lower the frequency of superior vena cava [SVC] obstruction, a frequent complication of central parenteral nutrition, is reported. The displacement of the end of the catheter by the infant's movements may damage the vessel wall and play an important role in the pathogenesis of the thrombosis and obstruction. The modified technique for catheter placement, because it avoids the ligation of the internal jugular vein and allows a better localization and fixation of the tip of the catheter which lies in the SVC, may contribute to the decrease in frequency of these complications.