Complications of superior versus inferior vena cava occlusion in infants receiving central total parenteral nutrition. 1984

S J Mulvihill, and E W Fonkalsrud

During a 9-year period, 204 infants younger than 12 months of age had 294 Broviac central venous hyperalimentation catheters inserted. Fifty-nine adult-size and 235 infant-size Broviac catheters were used. Catheter insertion was via the saphenous vein (267), external jugular (7), internal jugular (16), cephalic (2), and transthoracic right atrial veins (2). General anesthesia was used for all internal jugular, but for only 11 saphenous catheters. Catheter function ranged from 6 to 925 days (mean, 112 days). Forty-four infants had malabsorption syndromes, 36 had short bowel syndrome, 38 had intractable diarrhea, and 86 required nutritional support for a variety of other conditions. Fifteen of the 204 infants developed inferior (10) or superior vena caval thrombosis (2), or both (3). Thrombosis occurred in 13 of the 267 infants with saphenous catheters (4.9%), and five of the 25 with jugular or cephalic venous catheters (20.0%). Obstruction to normal catheter infusion was the first sign of caval occlusion. Transient mild leg edema (4) and prominent venous pattern over the legs (3) were present with inferior vena caval (IVC) occlusion, but no patient had renal vein obstruction or died as a direct result of this condition. Each of the two patients with superior vena caval (SVC) occlusion experienced mild to moderate edema and venous suffusion of the head and upper extremities, and one developed a pleural effusion. Each of the three infants with combined superior and inferior vena caval thrombosis died from pulmonary insufficiency within six months after SVC occlusion.(ABSTRACT TRUNCATED AT 250 WORDS)

UI MeSH Term Description Entries
D007223 Infant A child between 1 and 23 months of age. Infants
D007231 Infant, Newborn An infant during the first 28 days after birth. Neonate,Newborns,Infants, Newborn,Neonates,Newborn,Newborn Infant,Newborn Infants
D008297 Male Males
D010288 Parenteral Nutrition The administering of nutrients for assimilation and utilization by a patient who cannot maintain adequate nutrition by enteral feeding alone. Nutrients are administered by a route other than the alimentary canal (e.g., intravenously, subcutaneously). Intravenous Feeding,Nutrition, Parenteral,Parenteral Feeding,Feeding, Intravenous,Feeding, Parenteral,Feedings, Intravenous,Feedings, Parenteral,Intravenous Feedings,Parenteral Feedings
D010289 Parenteral Nutrition, Total The delivery of nutrients for assimilation and utilization by a patient whose sole source of nutrients is via solutions administered intravenously, subcutaneously, or by some other non-alimentary route. The basic components of TPN solutions are protein hydrolysates or free amino acid mixtures, monosaccharides, and electrolytes. Components are selected for their ability to reverse catabolism, promote anabolism, and build structural proteins. Hyperalimentation, Parenteral,Intravenous Hyperalimentation,Nutrition, Total Parenteral,Parenteral Hyperalimentation,Total Parenteral Nutrition,Hyperalimentation, Intravenous
D002404 Catheterization Use or insertion of a tubular device into a duct, blood vessel, hollow organ, or body cavity for injecting or withdrawing fluids for diagnostic or therapeutic purposes. It differs from INTUBATION in that the tube here is used to restore or maintain patency in obstructions. Cannulation,Cannulations,Catheterizations
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D013927 Thrombosis Formation and development of a thrombus or blood clot in BLOOD VESSELS. Atherothrombosis,Thrombus,Blood Clot,Blood Clots,Thromboses
D014682 Vena Cava, Inferior The venous trunk which receives blood from the lower extremities and from the pelvic and abdominal organs. Inferior Vena Cava,Inferior Vena Cavas,Vena Cavas, Inferior

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