Clinical Review: Vascular Access for Fluid Infusion in Children

Overview

Journal Crit Care

Specialty Critical Care

Date 2004 Nov 30

PMID 15566619

Citations 17

Authors

Nikolaus A Haas

Affiliations

Soon will be listed here.

Abstract

The current literature on venous access in infants and children for acute intravascular access in the routine situation and in emergency or intensive care settings is reviewed. The various techniques for facilitating venous cannulation, such as application of local warmth, transillumination techniques and epidermal nitroglycerine, are described. Preferred sites for central venous access in infants and children are the external and internal jugular veins, the subclavian and axillary veins, and the femoral vein. The femoral venous cannulation appears to be the most safe and reliable technique in children of all ages, with a high success and low complication rates. Evidence from the reviewed literature strongly supports the use of real-time ultrasound techniques for venous cannulation in infants and children. Additionally, in emergency situations the intraosseous access has almost completely replaced saphenous cutdown procedures in children and has decreased the need for immediate central venous access.

Citing Articles

Impact of the Warm Compress Method Conducted by Nurses Before Venipuncture on Blood Nitric Oxide Concentration.

Koike S, Norikura T, Taneichi A, Yasuda K, Yano R J Infus Nurs. 2025; 48(2):106-113.

PMID: 40047606 PMC: 11875400. DOI: 10.1097/NAN.0000000000000579.

Effectiveness of reinforcement program on adherence toward short peripheral catheter (SPC) care guidelines among registered nurses working in pediatric wards of a tertiary care hospital.

Shivani S, Joseph H J Educ Health Promot. 2023; 11:359.

PMID: 36618482 PMC: 9818619. DOI: 10.4103/jehp.jehp_511_22.

A review of peripherally inserted central catheters and various types of vascular access in very small children and pediatric patients and their potential complications.

Bahoush G, Salajegheh P, Anari A, Eshghi A, Aski B J Med Life. 2021; 14(3):298-309.

PMID: 34377194 PMC: 8321608. DOI: 10.25122/jml-2020-0011.

Comparison of two different intraosseous access methods in a physician-staffed helicopter emergency medical service - a quality assurance study.

Sorgjerd R, Sunde G, Heltne J Scand J Trauma Resusc Emerg Med. 2019; 27(1):15.

PMID: 30760297 PMC: 6373167. DOI: 10.1186/s13049-019-0594-6.

Declining Procedures by Pediatric Critical Care Medicine Fellowship Trainees.

Engorn B, Newth C, Klein M, Bragg E, Margolis R, Ross P Front Pediatr. 2018; 6:365.

PMID: 30555807 PMC: 6284024. DOI: 10.3389/fped.2018.00365.

References

Chen K . Clinical experience of percutaneous femoral venous catheterization in critically ill preterm infants less than 1,000 grams. Anesthesiology. 2001; 95(3):637-9. DOI: 10.1097/00000542-200109000-00015. View

Bellotti G, Bedford R, Arnold W . Fiberoptic transillumination for intravenous cannulation under general anesthesia. Anesth Analg. 1981; 60(5):348-51. View

Galpin R, Kronick J, Willis R, Frewen T . Bilateral lower extremity compartment syndromes secondary to intraosseous fluid resuscitation. J Pediatr Orthop. 1991; 11(6):773-6. DOI: 10.1097/01241398-199111000-00014. View

Soong W, Jeng M, Hwang B . The evaluation of percutaneous central venous catheters--a convenient technique in pediatric patients. Intensive Care Med. 1995; 21(9):759-65. DOI: 10.1007/BF01704744. View

Swanson R, Uhlig P, Gross P, McCabe C . Emergency intravenous access through the femoral vein. Ann Emerg Med. 1984; 13(4):244-7. DOI: 10.1016/s0196-0644(84)80471-0. View

Verghese S, Nath A, Zenger D, Patel R, Kaplan R, Patel K . The effects of the simulated Valsalva maneuver, liver compression, and/or Trendelenburg position on the cross-sectional area of the internal jugular vein in infants and young children. Anesth Analg. 2002; 94(2):250-4, table of contents. DOI: 10.1097/00000539-200202000-00004. View

Babl F, Vinci R, Bauchner H, Mottley L . Pediatric pre-hospital advanced life support care in an urban setting. Pediatr Emerg Care. 2001; 17(1):5-9. DOI: 10.1097/00006565-200102000-00002. View

Lohmann M, Moller P, Brynitz S, Bjerrum O . Nitroglycerin ointment as aid to venepuncture. Lancet. 1984; 1(8391):1416-7. DOI: 10.1016/s0140-6736(84)91918-4. View

Mallinson C, Bennett J, Hodgson P, Petros A . Position of the internal jugular vein in children. A study of the anatomy using ultrasonography. Paediatr Anaesth. 1999; 9(2):111-4. DOI: 10.1046/j.1460-9592.1999.9220329.x. View

10.

Finck C, Smith S, Jackson R, Wagner C . Percutaneous subclavian central venous catheterization in children younger than one year of age. Am Surg. 2002; 68(4):401-4. View

11.

Etheridge S, Berry J, Krabill K, Braunlin E . Echocardiographic-guided internal jugular venous cannulation in children with heart disease. Arch Pediatr Adolesc Med. 1995; 149(1):77-80. DOI: 10.1001/archpedi.1995.02170130079018. View

12.

Gualtieri E, Deppe S, Sipperly M, Thompson D . Subclavian venous catheterization: greater success rate for less experienced operators using ultrasound guidance. Crit Care Med. 1995; 23(4):692-7. DOI: 10.1097/00003246-199504000-00018. View

13.

Smith M . Internal jugular venous cannulation in children under 5 years of age. Can J Anaesth. 1990; 37(4 Pt 2):S102. View

14.

Khanlari B, Linder L, Haefeli W . Local effect of transdermal isosorbide dinitrate ointment on hand vein diameter. Eur J Clin Pharmacol. 2002; 57(10):701-4. DOI: 10.1007/s00228-001-0379-4. View

15.

Jaimovich D, Kecskes S . Intraosseous infusion: a re-discovered procedure as an alternative for pediatric vascular access. Indian J Pediatr. 1991; 58(3):329-34. DOI: 10.1007/BF02754960. View

16.

Johnson E, Saltzman D, Suh G, Dahms R, Leonard A . Complications and risks of central venous catheter placement in children. Surgery. 1998; 124(5):911-6. View

17.

Lake W, Emmerson A . Use of a butterfly as an intraosseous needle in an oedematous preterm infant. Arch Dis Child Fetal Neonatal Ed. 2003; 88(5):F409. PMC: 1721622. DOI: 10.1136/fn.88.5.f409. View

18.

La Fleche F, Slepin M, Vargas J, Milzman D . Iatrogenic bilateral tibial fractures after intraosseous infusion attempts in a 3-month-old infant. Ann Emerg Med. 1989; 18(10):1099-101. DOI: 10.1016/s0196-0644(89)80937-0. View

19.

Lukish J, Valladares E, Rodriguez C, Patel K, Bulas D, Newman K . Classical positioning decreases subclavian vein cross-sectional area in children. J Trauma. 2002; 53(2):272-5. DOI: 10.1097/00005373-200208000-00014. View

20.

Citak A, Karabocuoglu M, Ucsel R, Uzel N . Central venous catheters in pediatric patients--subclavian venous approach as the first choice. Pediatr Int. 2002; 44(1):83-6. DOI: 10.1046/j.1442-200x.2002.01509.x. View