Editorial Views  |   January 2018
Central Venous Catheters in Small Infants
Author Notes
  • From the Department of Anesthesia and Pain Management, Royal Children’s Hospital, Melbourne, Australia (C.B.); Anaesthesia and Pain Management Research Group, Murdoch Children’s Research Institute, Melbourne, Australia (C.B.); and the Department of Anesthesia, Intensive Care and Pain Management, Robert Debré University Hospital, Paris, France (S.M.).
  • Corresponding article on page 38.
    Corresponding article on page 38.×
  • Accepted for publication September 15, 2017.
    Accepted for publication September 15, 2017.×
  • Address correspondence to Dr. Brasher: christopher.brasher@rch.org.au
Article Information
Editorial Views / Pediatric Anesthesia / Technology / Equipment / Monitoring
Editorial Views   |   January 2018
Central Venous Catheters in Small Infants
Anesthesiology 1 2018, Vol.128, 4-5. doi:10.1097/ALN.0000000000001961
Anesthesiology 1 2018, Vol.128, 4-5. doi:10.1097/ALN.0000000000001961
HOW to best insert and maintain central venous catheters in small infants is a question of interest to all health professionals working in the field. The hospitalized small infant population is growing as extremely premature baby survival rates increase.1  In parallel, ultrasound technology is developing rapidly. Smaller vessel and catheter diameters imply increased technical difficulties during both insertion and maintenance when compared with larger children and adults. In this issue of Anesthesiology, Breschan et al.2  describe an experience in Austria with respect to central vein cannulation technique in preterm infants. In 2010, they decided to change their default central venous catheter cannulation technique to in-plane ultrasound-guided cannulation of the brachiocephalic vein in small infants. Their aim was to increase success rates and efficiency, and to reduce complications. One particular advantage of the target brachiocephalic vein is that it relatively maintains its diameter in hypovolemic and shocked patients. The detailed description of the technique, along with the pitfalls to be avoided, is of great potential interest to all anesthesiologists and, indeed, all practitioners inserting central venous catheters in small infants.
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