title: Minimizing complications associated with percutaneous central venous catheter placement in children: recent advances.
abstract: OBJECTIVE
  To summarize existing knowledge regarding the prevalence of complications associated with temporary percutaneous central venous catheters placed in critically ill children, and to review evolving strategies to minimize the prevalence of these complications.
  
  
  METHODS
  Literature review was performed: PubMed and EBSCOhost were searched using the terms central venous catheter, children, ultrasound, infection, thrombosis, and thromboembolism in various combinations. Citations of interest from identified articles were also reviewed.
  
  
  METHODS
  The review focused primarily on pediatric literature relevant to the topic of interest.
  
  
  METHODS
  Randomized clinical trials and other prospective studies were discussed in greater detail than retrospective, single-center investigations.
  
  
  CONCLUSIONS
  Complications during percutaneous central venous catheter placement in children are not rare and may be in part attributable to abnormalities in vascular anatomy. Thromboses in children with central venous catheters are increasingly recognized as an important problem for which evidence-based preventive measures are lacking. Catheter-associated bloodstream infection rates in critically ill children have markedly decreased over the last decade, associated with an increased emphasis on staff education and the use of insertion and maintenance bundles. Available evidence tends to support the use of two-dimensional ultrasound to augment the landmark technique for catheter placement, but more studies are needed.
authors: Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA. jmcostello@luriechildrens.org
authors: John M
authors: JM
authors: Costello
authors: Timothy C
authors: TC
authors: Clapper
authors: David
authors: D
authors: Wypij
mesh_terms: D001158:Arteries / Q000293:injuries*; D055499:Catheter-Related Infections / Q000517:prevention & control*; D002405:Catheterization, Central Venous / Q000009:adverse effects / Q000379:methods*; D002648:Child; D003422:Critical Care; D006801:Humans; D011030:Pneumothorax / Q000209:etiology / Q000517:prevention & control*; D013927:Thrombosis / Q000209:etiology / Q000517:prevention & control*; D018084:Ultrasonography, Interventional; D014950:Wounds, Penetrating / Q000209:etiology / Q000517:prevention & control*