Vascular Access in Neonates and Children: Techniques for the Pediatric Surgeon

Vascular access in infants and small children can be challenging, particularly when standard techniques are unavailable or unsuitable. In this manuscript, we describe alternative approaches for establishing vascular access in pediatric patients, especially those with conditions that contraindicate conventional access methods. These techniques were used routinely before the widespread adoption of peripherally inserted central catheters (PICC) lines. While a surgeon certainly is capable of placing a PICC line, these procedures are generally performed by non-physicians as part of a vascular access team.