Rapid technological advances have made possible interventions that have significantly improved the survival of sick infants and children. Notable among these is the use of intravascular catheters in the treatment of critically ill pediatric patients, particularly premature infants and other high-risk neonates. These advances have led to improved survival; unfortunately, they have been associated with multiple complications that result in morbidity and mortality. The increasing list of complications is extended by Daniels et al1 in this issue of the AJDC in a report on paroxysmal supraventricular tachycardia, resulting from right atrial positioning of a central venous catheter in a neonate.
The complications of arterial and venous catheters fall into several causal categories: perforation, sepsis, vessel scarring, improper placement, thrombotic and embolic events, and other causes. The relative risks of arterial v venous placement and the preferable position of the tip of umbilical arterial catheters will not be discussed beyond