MOST CHILDREN WITH SOLID TUMORS require intensive treatment, including surgery, chemotherapy, intravenous (IV) fluids, IV antibiotics, blood and platelet transfusions, frequent blood sampling, and sometimes IV nutrition. Venous catheters provide a very effective method for allowing entry into the large veins for intensive therapy. They eliminate the difficulty of finding veins for IVs and allow drugs to be put directly into the heart, where they are rapidly diluted and spread throughout the body. They also reduce stress and discomfort for the child by eliminating the need for hundreds of needle sticks.

The three types of venous catheters are external catheters, subcutaneous ports, and peripherally inserted central catheters (PICC). Other names for a venous catheter include venous access device, right atrial catheter, implanted catheter, indwelling catheter, central line, Hickman^®, Broviac^®, PORT-A-CATH^®, and Medi-port^®.

This chapter first describes external, implanted, and PICC catheters—what they look like, how they are placed, the care they need, and their risks. It then compares the costs of venous cathers and the various types of adhesives that can be used to secure the lines in place. The final part of the chapter offers information to help families decide which catheter to choose.