ABSTRACT
Secure vascular access is central to the delivery of many aspects of modern medical care. In 1628, William Harvey described the heart and circulation in detail. This provided the anatomical basis for subsequent vascular interventions. Venous and arterial access is a key part of the management of many children who require investigations, monitoring, and specific interventions. The large number of central venous access devices fall into two broad categories: non-tunneled catheters and tunneled catheters. The type of central venous access device used will depend on the requirements of the individual child. For the purposes of central venous access, the central veins may be defined as the superior vena cava, the right atrium, and the suprahepatic inferior vena cava. Anesthetic should be appropriate to the complexity of the child undergoing surgery. Anesthetic strategies for vascular access procedures in children differ widely between centers. Intravenous sedation may be used with good results.
