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- Title
Special Consideration in Vascular Access for Neonatal and Pediatric Patients.
- Authors
Merritt, Laurel; Doolin, Ellie
- Abstract
Motivation There are limited resources to guide clinicians for line size and tip location in highly specific neonatal and pediatric populations including congenital heart surgical/medical, NICU, and PICU patients. Several of these patients have abnormal vasculature. Unfortunately, we are oftentimes unable to follow the best practice guidelines for less than 30% vessel occupancy and/or tip locations in the lower onethird of the SVC. Purpose We would like to assess patient outcomes in relation to percentage vessel occupancy and tip location. In these patients with atypical anatomy and unique needs, catheter tips are frequently outside of our usual standards in the smaller populations related to age or diagnosis. We are undertaking this study to collect data that can be used to establish acceptable percentage occupancy in relation to the age and size of patients. Approach We are conducting a retrospective chart review to assess patient outcomes in relationship to age, size, vessel selection, percentage occupancy, tip location, abnormal vasculature, and any undesirable outcomes. Undesirable outcomes include line failure, thrombus, catheter occlusion, alteplase usage, and infection. Thrombus finding on echocardiogram will also be reviewed on congenital heart surgery patients. Results We suspect that after evaluating all of the data, we will find the percentage of vessel occlusion can increase with decreasing age. We also hypothesize that the tip location outside the SVC will not show increased undesirable outcomes in congenital heart patients. At the time of submission, the results are still in process. Conclusions Existing guidelines are based on patients with normal anatomy. We aim to develop data that can be useful for these patients but also insightful for patients with anomalous anatomy or special needs. We hope our results will contribute to evidence that can be used to develop best practice guidelines for pediatric and neonatal patients overall. We would like to see more data in highly specific neonatal and pediatric populations in regard to vessel selection and tip location for clinicians to base their practice on.
- Subjects
BLOOD vessels; CATHETERIZATION; CATHETERIZATION complications; INTENSIVE care units; MEDICAL equipment; MEDICAL protocols; NEONATAL intensive care; PEDIATRICS; NEONATAL intensive care units; RETROSPECTIVE studies
- Publication
Vascular Access, 2014, Vol 8, Issue 1, p20
- ISSN
1913-6692
- Publication type
Article