European Journal of Molecular & Clinical Medicine

Abstract

Background: Neonates pose a challenge in Neonatal intensive care unit (NICU) for central vascular access, which represents a daily practice. We have reported our experience with Central venous cut down through long saphenous vein (LSV) at sapheno-femoral junction (SF), its indications, feasibility and complications.
Objective: To assess the feasibility of insertion of central line by Sapheno-femoral (SF) cut down.
Methods: This is a retrospective study carried out in a Tertiary care hospital in a Metropolitan city of India. All the neonates who required Central venous access were included in the study.
Results: In our setting 176 neonates required LSV cut down for vascular access over a period of 3 years (2019-2022). The mean weight of the neonates was 1980 grams (range 680-4.1kg). The mean day at which the catheter was inserted was 7.1 days. Out of 176 neonates 8 neonates required vascular access for surgical condition and remaining 168 for medical condition. In 10 neonates the central line was inserted in operation theatre under general anesthesia. In the remaining 166 neonates the catheter was inserted in NICU under local anaesthesia. The mean time required for insertion of catheter was 14.2 minutes. The most common indications for Central line insertion included Sepsis, Respiratory distress syndrome, prematurity. The complications of CVL in our setting were central line induced sepsis followed by limb oedema.
Conclusion: Open surgical cut down of long Saphenous vein is feasible and a safe procedure, It can be performed as a bedside procedure without the need for General anaesthesia.