Use of the arm as long permanence central venous cateter insertion site in children: experience of the pediatric surgery department at Instituto Nacional de Câncer - Rio de Janeiro

Abstract

Objective: To report our experience with insertion and use of LTCVC in the arm. Pacients and Methods: It is a retrospective study. We analyzed 586 LTCVC inserted on children with cancer, from January 1995 to December 1999. Results: From a total of 586 inserted LTCVC; 536 (91,5%) were in the arm, 45 in the thorax and 5 were inserted in other sites. The vein of choice for the arm was the brachial vein, on its proximal third. All LTCVC were inserted at operating rooms, under general anesthesia. The tip of the catheter was localized on superior cava vein under fluoroscopy. Our experience with the site of insertion on the arm had demonstrated that this site is safe, comfortable, esthetically better, and that it allows more mobility to the patients when it is activated. The results regarding infection rates for arm insertionare similar to those found on the literature for LTCVC thorax inserted. Conclusion: We indicate the arm (brachial vein) as the site of choice for inserting LTCVC for children with cancer. Clinical Implication: The insertion of LTCVC in the arm is a safe and efficient option for inserting LTCVC in children with cancer.