Vascular access techniques and devices in the pediatric patient.

Vascular access is a sine qua non in the management of pediatric surgical patients. The indications, as well as the number of available access routes, types of devices, and their use, have expanded over the last two decades. This article is an overview intended to allow the surgeon to match the safest and most effective access to the child's therapeutic needs. It also contains descriptions of sites for percutaneous and cut-down vascular access in children, as well as the author's personal approach to central venous access. Vascular access in children requires skill, time, patience, and the appropriate equipment. Fortunately, with attention to detail, most complications can be avoided.