Cost-effective central venous line for infants in the developing world.
BACKGROUND
The aim of the study was to look into the feasibility, safety, efficacy and cost-effectiveness of utilising the remains of central venous catheters in infants from a developing country.


METHODS
Between June 2005 and December 2006, 96 neonates and infants with various illnesses and required the insertion of central venous access, were divided into two groups; those who required it for a short to medium term (44 patients) received a piece of the remains of catheters, and those who required conventional catheter insertion intended for long-term use (52 patients) received a regular catheter. The same principle of insertion was used as for regular central venous access. The external jugular vein was used when possible or the internal jugular vein was used otherwise. After appropriate insertion, the catheter was mounted on an appropriately-sized cannula. A three-way stopcock connection was used to minimise manipulation of the cannula. Postoperative care was the same as for routine central venous lines. Complications encountered in the two groups were recorded and analysed.


RESULTS
Of the short- and medium-term catheters, 32 out of 44 patients (72.7 percent) completed the intended course of treatment successfully, and of the long-term catheters, 42 out of 52 patients (80.8 percent) completed the treatment successfully. Recorded complications were dislodgement, thrombosis and infection. These were, in the short-term group, as follows: five (11.4 percent), three (6.8 percent) and four (9.1 percent), respectively; and for the long-term group, two (3.8 percent), four (7.7 percent) and four (7.7 percent), respectively.


CONCLUSIONS
Utilisation of the remains of venous catheters in properly-selected patients for short- and medium-term treatment is feasible, cost-effective and safe, and the rates of complications are comparable to cases with conventional catheter insertion.
Saleem
M M
MM
Department of Paediatric Surgery, Jordan University Hospital, PO Box 13546, Amman 11942, Jordan. mohomari@hotmail.com
D002405:Catheterization, Central Venous / Q000009:adverse effects / Q000191:economics*; D002408:Catheters, Indwelling / Q000009:adverse effects / Q000191:economics; D003362:Cost-Benefit Analysis; D003906:Developing Countries; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007223:Infant; D007224:Infant Care; D007231:Infant, Newborn; D008297:Male