ABSTRACT
Rare complications of vascular access are inability to remove catheter, adverse reaction to catheter material, Horner's syndrome, and cervical oropharyngeal oedema, back pain, aortoarterial/aortovenous fistula, glomerulonephritis, vocal cord paralysis, skin erosion over venous port catheter, superior vena cava syndrome and chest pain. Where possible the approach for central venous access in a neonate with gastroschisis should be a peripherally inserted central venous catheter. This allows for administration of parenteral nutrition without compromising the major veins. Gastroschisis is a major cause for intestinal failure and central veins should be preserved for as long as possible. In patients who require infrequent venous sampling or central medication such as sickle-cell anaemia or metabolic disorders, a central venous port is used. Regular venous access for administration of coagulation factors is central to the management of patients with haemophilia. Up to two-thirds of children with severe haemophilia may have an implantable central venous access device.
