Techniques, Materials, and Devices Percutaneous and Surgical Placement of Fine Silicone Elastomer Central Catheters in High-Risk Newborns

ABSTRACT. Percutaneous insertion of fine silicone elastomer catheters (0.6 millimeters outside diameter) have been used for central parenteral nutrition of very low birth weight and other high risk infants. Because peripheral venous access can be limited in the newborn, we report the previously undescribed surgical cannulation of the superficial arm veins with this catheter, and compare our experience with this technique and the percutaneous method in neonates. A central catheter posi-tion was attained in 88 % of surgical (38 of 43) and 74 % of percutaneous (17 of 23) cannulations. The two groups did not differ in birth weight or gestational age. The mean duration of catheterization was similar in the two groups (combined X = 21.8 ± 2.3 days SEM). There was no difference in weight gain (combined X = 16.9 ± 1.0 grams SEM per day) or head growth (combined X = 1.1 ± 0.1 millimeters per day) between th