{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T10:10:40Z","timestamp":1779185440291,"version":"3.51.4"},"reference-count":20,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2013,9,19]],"date-time":"2013-09-19T00:00:00Z","timestamp":1379548800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pediatric Anesthesia"],"published-print":{"date-parts":[[2013,11]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>A central venous catheter located in the jugular or subclavian vein provides rapid, reliable vascular access for pediatric heart surgery. However, intravascular catheters are associated with vessel injury. Stenosis or thrombosis of central veins in the upper body can lead to \u2018superior vena cava syndrome\u2019 with markedly elevated venous pressures in the head and neck, causing facial swelling and headaches. This complication may be especially serious for patients with superior cavopulmonary (Glenn) or total cavopulmonary (<jats:styled-content style=\"fixed-case\">F<\/jats:styled-content>ontan) circulation. The authors hypothesized that upper body central line placement would be associated with a low risk of venous thrombosis or stenosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A three\u2010year retrospective review of infant and univentricular cardiac procedures at a single institution was performed. Two hundred and thirty\u2010five consecutive cardiac surgical patients &lt;1\u00a0year of age or undergoing palliation for univentricular cardiac anatomy up to five years of age during January 2010 to December 2012 were included in this study. Upper body central lines are routinely placed by the anesthesiologist after induction of anesthesia for pediatric cardiac surgery at the study institution. The major exception is existing central venous access via an umbilical vein or femoral vein. Patients &lt;2\u00a0years of age received a 4.0\u2010French, 5\u2010cm double\u2010lumen central line [Cook Medical polyurethane, no antibiotic or heparin coating]. Those over two years of age received a 5.0\u2010French, 8\u2010cm triple lumen central line [Cook Medical polyurethane, no antibiotic or heparin coating]. A retrospective review of charts, hospital reports, echocardiographic studies, and cardiac catheterization studies was performed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The combined population of infants &lt;1\u00a0year of age and patients &lt;5\u00a0years of age with functional univentricular hearts totaled 235 patients who underwent 261 cardiac surgical operations. In this cohort of 261 cases, 171 size 4.0 or 5.0\u2010French upper body central lines were inserted. A total of 158 right internal jugular vein catheters were placed. Two left internal jugular lines, two left subclavian lines, and nine right subclavian lines were placed in this population after failure to obtain right internal jugular access. Due to the small sample size (<jats:italic>N<\/jats:italic>\u00a0=\u00a013), the central lines not placed in the right internal jugular vein were excluded from further review. Two cases with right internal jugular venous lines were excluded due to death (without known stenosis or thrombosis) with the line in place. Twenty\u2010three size 4.0\u2010 or 5.0\u2010French right internal jugular central venous lines were placed in patients over one year of age (range 1.1\u20134.3\u00a0years) having modified Glenn\u2010 or Fontan\u2010type surgery. The central lines were removed with a median of 1.4\u00a0days after insertion (range 0.7\u20138.2\u00a0days) for these older children, compared with a median of 4.2\u00a0days of age (range 0.3\u201319.3\u00a0days) for the 133 children &lt;1\u00a0year of age. Retrospective chart review of nursing notes, progress notes, cardiology notes, discharge summaries, echocardiographic reports, and cardiac catheterization reports for all patients who received an upper body central venous line (internal jugular or subclavian) showed no definitive diagnosis of an upper body venous stenosis or thrombosis related to the central venous line. A further targeted review of echocardiographic and cardiac catheterization studies for univentricular cardiac patients failed to show stenosis or thrombosis of a vessel associated with upper body central line placement.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This study describes one institution's experience with routine upper body central venous catheter placement for neonatal and infant cardiac surgery as well as univentricular cardiac palliation (Glenn and Fontan procedures) with minimal risk of clinically significant catheter\u2010associated vessel thrombosis or stenosis. No upper body central venous stenosis or thrombosis was detected in association with perioperative catheter placement in the upper body central venous system, primarily the right internal jugular vein in 156 cases. Right internal jugular central line placement for infant cardiac surgery can be utilized with a low risk of direct venous thrombosis or stenosis.<\/jats:p><\/jats:sec>","DOI":"10.1111\/pan.12261","type":"journal-article","created":{"date-parts":[[2013,10,3]],"date-time":"2013-10-03T06:50:35Z","timestamp":1380783035000},"page":"980-988","source":"Crossref","is-referenced-by-count":24,"title":["Upper body central venous catheters in pediatric cardiac surgery"],"prefix":"10.1111","volume":"23","author":[{"given":"Jeffrey W.","family":"Miller","sequence":"first","affiliation":[{"name":"Division of Pediatric Cardiac Anesthesiology Congenital Heart Institute of Florida Tampa USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dien N.","family":"Vu","sequence":"additional","affiliation":[{"name":"Division of Pediatric Cardiac Anesthesiology Congenital Heart Institute of Florida Tampa USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul J.","family":"Chai","sequence":"additional","affiliation":[{"name":"Department of Pediatric Cardiac Surgery Johns Hopkins Children's Heart Surgery Tampa USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Janet H.","family":"Kreutzer","sequence":"additional","affiliation":[{"name":"Pediatric Cardiac Surgery Outcomes Research St. Joseph's Children's Hospital Tampa USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J. Blaine","family":"John","sequence":"additional","affiliation":[{"name":"Division of Pediatric Cardiology Congenital Heart Institute of Florida St. Petersburg USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David F.","family":"Vener","sequence":"additional","affiliation":[{"name":"Department of Anesthesia Division of Pediatric Cardiac Anesthesia Texas Children's Hospital\/Baylor College of Medicine Houston TX USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeffrey P.","family":"Jacobs","sequence":"additional","affiliation":[{"name":"Department of Pediatric Cardiac Surgery Johns Hopkins Children's Heart Surgery St. Petersburg USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2013,9,19]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1542\/peds.72.1.109","article-title":"Recurrent bilateral pleural effusions secondary to superior vena cava obstruction as a complication of central venous catheterization","volume":"72","author":"Dhande V","year":"1983","journal-title":"Pediatrics"},{"key":"e_1_2_10_3_1","first-page":"26","article-title":"Central venous catheterization and thrombosis in newborns: update on diagnosis and management","volume":"25","author":"Sellilto M","year":"2012","journal-title":"J Matern Fetal Med"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1525-139X.2007.00242.x"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.2010.026989"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/MOP.0b013e3283534b7f"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8159.1998.tb00238.x"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.110.006304"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.20356"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.10206"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1460-9592.2008.02662.x"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/MBC.0b013e3283548e39"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2012.03.043"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1086\/655017"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0b013e31827bd172"},{"key":"e_1_2_10_16_1","first-page":"CD002772","article-title":"Continuous heparin infusion to prevent thrombosis and catheter occlusion in neonates with peripherally placed percutaneous central venous catheters","volume":"2","author":"Shah PS","year":"2008","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2012.06.070"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1067\/mpd.2002.119591"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2009.03.071"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1097\/PCC.0b013e31824fbdb4"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1983.03330370053031"}],"container-title":["Pediatric Anesthesia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fpan.12261","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/pan.12261","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,1]],"date-time":"2023-10-01T21:19:17Z","timestamp":1696195157000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/pan.12261"}},"subtitle":[],"editor":[{"given":"Greg","family":"Hammer","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2013,9,19]]},"references-count":20,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2013,11]]}},"alternative-id":["10.1111\/pan.12261"],"URL":"https:\/\/doi.org\/10.1111\/pan.12261","archive":["Portico"],"relation":{},"ISSN":["1155-5645","1460-9592"],"issn-type":[{"value":"1155-5645","type":"print"},{"value":"1460-9592","type":"electronic"}],"subject":[],"published":{"date-parts":[[2013,9,19]]}}}