• Lori A Duesing, Jason A Fawley, and Amy J Wagner.
• Division of Pediatric Neurosurgery, Medical College of Wisconsin, Children's Hospital of Wisconsin, Milwaukee, Wisconsin, USA lduesing@mcw.edu.
• Nutr Clin Pract. 2016 Aug 1; 31 (4): 490-501.

AbstractCentral venous catheters are often necessary in the pediatric population. Access may be challenging, and each vessel presents its own unique set of risks and complications. Central venous catheterization is useful for hemodynamic monitoring, rapid fluid infusion, and administration of hyperosmolar medications, including vasopressors, antibiotics, chemotherapy, and parenteral nutrition. Recent advances have improved the catheters used as well as techniques for insertion. A serious complication of central access is infection, which is associated with morbidity, mortality, and significant financial costs. Reduction of catheter-related bloodstream infections is realized with use of ethanol locks, single lumens when appropriate, and prudent adherence to insertion and maintenance bundles. Ultrasound guidance used for central venous catheter placement improves accuracy of placement, reducing time and unsuccessful insertion and complication rates. Patients with central venous catheters are best served by multidisciplinary team involvement. © 2016 American Society for Parenteral and Enteral Nutrition.

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