Effect of fluoroscopy in central vein catheterization in children

Aim: In this study, we aimed to evaluate the effect of fluoroscopy on the prevention of malposition during placement of central venous catheters (CVC) in children, complications that occur during the procedure and follow-up and associated risk factors. Material and Methods: A total of 87 central venous catheter placement procedures performed in 59 pediatric patients under fluoroscopy between 2014 and 2016 were included in the study. Demographic data, catheter insertion site, indication, number of attempts, catheter diameter, insertion time, complications during insertion and follow-up were recorded. Results: The mean age of the cases was 5 months (1-28 months), and the mean body weight was 4.64 kg (1-14). Catheter insertions were mostly performed through the jugular vein. The femoral location was used in emergency situations in 12 patients (13.7%); 36.8% of catheter placements were used to provide peripheral vascular access, 59.8% were used for parenteral nutrition, intravenous fluid and inotropic support, and 3.4% for chemotherapy. Complications occurred during catheter placement in 29 of the patients. The most common intervention complication was arterial puncture. Complications in the right jugular and subclavian regions were more common than in other regions (p=0.015). Malposition or kinking of the catheter was not observed during the placement. Arterial puncture and pneumothorax/hemothorax were encountered more frequently as the number of attempts increased (p= 0.001). Catheterrelated bloodstream infection was the most common complication and was observed in 11 (12.6%) catheters. Discussion: Various complications may be encountered during placement and monitoring in CVC applications in pediatric patients. Using fluoroscopy during placement reduces complications such as malposition and arrhythmia.