Clincal Trial of Percutaneous Central Vein Catherization Via Great Saphenous Vein

ABSTRACT

PURPOSE: We performed a comparative study on clinical impacts in the neonatas in the neonatal intensive care unit (NICU), who received vascular access through percutaneous central venous catheterization (PCVC), between one group via vessels of upper extremity, and the other group via the great saphenous vein. METHODS: We evaluated a total of 158 PCVC cases performed in the NICU of Soonchunhyang Chunan Hospital over 1 year 8 months from January, 1997 to September, 1998. The 134 cases of PCVC were performed via veins located on upper extremity and 34 cases of this procedures were performed via veins located on the great saphenous vein. We have compared success rates, clinical characteristics, indwelling time, causes of removal of the catheters, and associated complication between both upper extremity group and the great saphenous vein group retrospectively. RESULTS: There were no significant differences in the mean gestational age, birth weight, weight at the time of insertion between two groups. There were no significant differences in indwelling time between two groups, 20.0+/-12.8 days in upper extremity group, and 13.1+/-4.4 days in great saphenous vein group respectively (P<0.1). The overall success rate of insertions was 94.9% (150/158), the success rate of upper extremity group was 96.3% (129/134) and great saphenous vein group was 87.5% (21/24) and there were no significant differences. The most common site of tip of catheter was right atrium in both groups, that was confirmed by radiologic evaluation after venous access. The common cause of removal of the catheter was elective in both groups. Another secondary common cause of removal was mechanical complication, the rate of which was 17.1% in upper extremity group, 33.3% in great saphenous vein group. CONCLUSION: We found that there were no significant differences on success rate of insertion of central venous catheter between two groups and the rate of removal of catheter from mechanical complication caused by obstruction of it were higher in great saphenous vein group, than upper extremity group in comparison. Accordingly, further study should be performed about handling and management of central venous catheter after catherization via great saphenous vein.