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Pediatric Cardiology

, Volume 40, Issue 4, pp 733–737 | Cite as

Complications of Transthoracic Intracardiac and Central Venous Lines in Neonates Undergoing Cardiac Surgery

  • Mary Lyn Stein
  • Luis G. Quinonez
  • James A. DiNardo
  • Morgan L. BrownEmail author
Original Article

Abstract

Neonates undergoing congenital heart surgery require central venous access for diagnostic information and medication administration. There are multiple options for central access including peripherally inserted central catheters, umbilical, central venous, and transthoracic intracardiac lines. We retrospectively identified all patients younger than 30 days who underwent cardiac surgery in a 1-year period. Data were collected on demographic and medical characteristics, adverse events, pre-emptive transfusion of blood products prior to line removal, and transfusion of blood products following removal of transthoracic intracardiac lines and central venous lines. In our cohort of 124 neonates, 176 transthoracic intracardiac lines were placed in 113 patients. Eighty-two patients had pre-existing central venous access including 35 umbilical venous lines, 21 PICC lines, and 18 CVLs. Ninety-eight patients received a CVL in the operating room by anesthesia. Five patients were transfused to correct laboratory derangement prior to transthoracic intracardiac line removal. Transfusion of packed red blood cells (pRBC) occurred after transthoracic intracardiac line removal in 25 patients. Thrombus formation was present in one patient with a transthoracic intracardiac line and three patients with CVLs. One patient underwent surgical intervention for repositioning of a transthoracic intracardiac line. There were no cases of cardiac arrest, extracorporeal life support, or deaths attributable to lines. In this cohort, transthoracic intracardiac lines were generally safe. There were very few complications of thrombus, infection, or requirement for surgical intervention; however, transfusion of pRBCs following transthoracic intracardiac line removal occurred in 20% of patients.

Keywords

Anesthesia Neonate Transfusion Vascular access 

Notes

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflicts of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments.

Informed Consent

Informed consent was waived by the Institutional Review Board for this retrospective cohort study.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Anesthesiology, Critical Care and Pain MedicineBoston Children’s HospitalBostonUSA
  2. 2.Division of Cardiovascular SurgeryBoston Children’s HospitalBostonUSA
  3. 3.Department of Anesthesiology, Critical Care and Pain Medicine, Division of Cardiac AnesthesiaBoston Children’s HospitalBostonUSA

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