Radiographic aspects of total parenteral nutrition during infancy.

In a retrospective radiographic study the authors reviewed the position of 82 central venous catheters in 57 consecutive infants receiving total parenteral nutrition between 1972 and 1976. Sixteen of the 82 catheters (19%) were initially not positioned within the superior vena cava and 11 (14%) migrated from a satisfactory position during therapy; peripheral edema, pleural effusion, and vascular thrombosis occurred more frequently in this group than in those infants with the catheter remaining in the superior vena cava. Unusual complications of intersititial pulmonary edema, hydrocephalus, and cardiac arrhythmia were noted in three different patients. An increased incidence of clinical complications is associated with catheter malposition or migration during total parenteral nutritional therapy. Radiographic monitoring with repositioning or removal of a malpositioned catheter may reduce the number of clinical complications.