Introduction: Central venous catheters allow measurement of hemodynamic variables that cannot be measured accurately by noninvasive means and allow delivery of medications and nutritional support that cannot be given safely through peripheral venous catheters. For this purpose many clinicians are using direct or indirect methods for jugular or subclavien vein catheterization. We report a 7.5 month old, 7200 gram female liver transplant recipient with neonatal cholestatic hepatitis. In the operation room with the indirect method right jugular venous catheterization was tried but it failed so again with the indirect (seldinger method) right subclavien vein catheterization was done. While replacing the catheter, no arrhythmias were seen on the monitor. After the aspiration of blood, catheter was fixed at the eighth cm. During the operation, central venous pressure measurements and fluid support was given through this catheter. At the lung graphy which was taken at the end of the operation (approximately 12 hours in duration), the endpoint of the catheter was seen in the right jugular vein. The catheter was used 2 more days for fluid replacement and was later removed. Because of the different vessel sizes, more angularizations of vessels and short subclavien and jugular veins, central venous catheterizations are more difficult in babies and children. Malpositioning of the catheter is the most common reason of the early catheter malfunctions. In conclusion, we believed that catheterization with the direct method can decrease the malposition rates of the catheters.
Volume : 6
Issue : 4
Pages : 120
Department of Surgery, Gazi University, Ankara, Turkey