title: Overcoming a kinked peel-away sheath during central line implantation.
abstract: In pediatric patients, central line implantation via the subclavian vein can be complicated by the presence of a kink in the peel-away sheath. A technique is described, which has been used on 62 occasions to overcome this problem. Reinserting the catheter through the kinked peel-away sheath in concert with a guidewire that extends 3 to 4 cm beyond the catheter tip can ensure successful placement.
authors.affiliation: Division of Pediatric Surgery, Children's Hospital of Los Angeles, CA 90027.
authors.forename: J B
authors.initials: JB
authors.lastname: Atkinson
authors.forename: K L
authors.initials: KL
authors.lastname: Chamberlin
authors.forename: J
authors.initials: J
authors.lastname: de Csepel
authors.forename: M
authors.initials: M
authors.lastname: Srikanth
mesh_terms: D002405:Catheterization, Central Venous / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D002408:Catheters, Indwelling; D002648:Child; D004867:Equipment Design; D005471:Fluoroscopy; D006801:Humans; D007231:Infant, Newborn; D013350:Subclavian Vein; D016896:Treatment Outcome