Pediatric central line
Size
| Age (yrs) | Internal Jugular | Subclavian | Femoral |
| 0-0.5 | 3F | 3F | 3F |
| 0.5-2 | 3F | 3F | 3-4F |
| 3-6 | 4F | 4F | 4-5F |
| 7-12 | 4-5F | 4-5F | 5-8F |
Insertion Distance
Initial length of insertion (cm) = 1.7 + [(0.07 x height (cm)][1]
Contraindications
Absolute[2]
- Infection over the placement site
- Anatomic obstruction (thrombosis of target vein, other anatomic variance)
- Site-specific
- Subclavian - trauma/fracture to ipsilateral clavicle or proximal ribs
Relative
- Coagulopathy (see below)
- Distortion of landmarks by trauma or congenital anomalies
- Prior vessel injury or procedures
- Morbid obesity
- Uncooperative/combative patient
Central line if coagulopathic
- Preferentially use a compressible site such as the femoral location (avoid the IJ and subclavian if possible, though IJ preferred over subclavian)
- No benefit to giving FFP unless artery is punctured[3]
- However, consider giving FFP if patient has hemophilia[4]
See Also
Vascular access types
- Central venous catheterization
- Rapid infusion catheter
- Intraosseous access
- Venous cutdown
- Umbilical vein catheterization
- Ultrasound assisted peripheral line placement
- External jugular vein cannulation
- The "Easy IJ"
- Midlines
References
- ↑ http://110.164.68.227/homelibrary/rj_online/Acta_anes/2006/Vol.50/No.3March/Depth355.pdf Yoon, S. et al Depth of a central venous catheter tip: length of insertion guideline for pediatric patients. Acta Anaesthesiol Scand 2006; 50: 355—357
- ↑ Graham, A.S., et al. Central Venous Catheterization. N Engl J Med 2007;356:e21
- ↑ Fisher NC, Mutimer DJ. Central venous cannulation in patients with liver disease and coagulopathy—a prospective audit. Intens Care Med 1999; 25:5
- ↑ Morado M.et al. Complications of central venous catheters in patients with haemophilia and inhibitors. Haemophilia 2001; 7:551–556