Which catheter is used in pediatric?

In pediatric care, catheter usage requires special caution, especially when selecting a catheter suitable for children. Compared to adults, children have smaller and more sensitive anatomies. Therefore, factors like catheter size, material, and type need extra consideration to ensure safety, comfort, and reduced infection risks. Below is an overview of common pediatric catheter types and their applications.

  Intermittent Catheter

I. Basic Requirements for Pediatric Catheters

When choosing a catheter for children, several important factors must be taken into account:

Catheter Size: Pediatric catheters are generally smaller to suit the anatomy of children’s urethra and bladder. Catheter size is usually measured in French (Fr) units, with pediatric catheters commonly ranging from 6 to 10 Fr.

Material Selection: Soft, non-irritating materials are essential in pediatric catheterization. Common materials include silicone, latex, and thermoplastic polyurethane. Among these, silicone is highly durable and biocompatible, making it a preferred choice for prolonged use.

Duration of Catheterization: The type of catheter chosen depends on whether it is for short-term or long-term use. Intermittent catheterization is suitable for short-term needs, while Foley catheters are preferred for indwelling (long-term) use.

II. Main Types of Pediatric Catheters

Foley Indwelling Catheter

Foley catheters are intended for temporary or long-term indwelling use. They are inserted through the urethra and anchored in the bladder by a small balloon. Pediatric Foley catheters come in sizes and balloon capacities suitable for children’s bladders, typically ranging from 6 to 10 Fr, making them appropriate for different age groups. Silicone Foley catheters are particularly suitable for prolonged use because they cause minimal tissue irritation and are hypoallergenic. Foley catheters are commonly used in cases of urinary retention or after surgery for short-term drainage.

Intermittent Catheter

Intermittent catheters (IC) are mainly used for short-term catheterization, ideal for children who need regular, self-catheterization. These flexible catheters allow children to insert the catheter, empty their bladder, and then remove it. In recent years, hydrophilic catheters have become increasingly popular in pediatrics. These pre-lubricated catheters come coated with a lubricant layer, requiring no additional lubrication for insertion, greatly reducing discomfort and friction. This makes them suitable for sensitive pediatric tissue. They are also single-use, lowering the risk of infection.

Suprapubic Catheter

A suprapubic catheter is inserted above the pubic bone directly into the bladder, making it ideal for children who require long-term catheterization but have difficulty with urethral insertion. This method avoids urethral trauma and is particularly beneficial for children with urethral strictures, congenital urethral obstruction, or complex urological abnormalities. Though this technique requires minor surgery, it is an effective and comfortable alternative when needed. Pediatric suprapubic catheters are generally made of silicone or other highly biocompatible materials to reduce infection risks and complications.

Neonatal Catheters

For neonates and preterm infants, who have exceptionally small and delicate urethras and bladders, specialized micro-catheters are required. Neonatal catheters are often extremely thin, and in some cases, soft feeding tubes can serve as catheters. Inserting these catheters requires great skill and a delicate touch to avoid damaging organs. These catheters are used in cases of neonatal urinary retention, urinary obstruction, and in neonatal intensive care units (NICU) where real-time urine monitoring is essential. The material must be soft and non-toxic, often made of silicone, to ensure comfort during insertion.

Intravenous Catheters (such as Umbilical Catheters)

In neonatal intensive care, umbilical venous or arterial catheters are often used. Although these differ from traditional urinary catheters, they provide critical access to a newborn’s circulatory system for blood sampling, medication, or intravenous fluid administration. For some newborns who require comprehensive care, these catheters can indirectly assist with urine and fluid monitoring.

III. Catheter Selection and Use by Age Group

Catheter choices and requirements vary with children's stages of development and their specific needs:

Infants (0–2 years): Generally, very thin catheters around 6 Fr are used. Catheters for this age group need to be made from soft, biocompatible materials to avoid tissue damage.

Children (3–10 years): Catheters of slightly larger sizes (around 8 Fr) may be suitable, and pre-lubricated intermittent catheters are preferred for increased comfort.

Adolescents (11 years and older): Catheter sizes similar to those used in adults (10 Fr or larger) can be considered. For adolescents requiring regular catheterization, semi-permanent Foley or intermittent catheters may be used.

IV. Key Considerations for Pediatric Catheter Use

Preventing Infection: Infection is a common risk in catheterization. Proper cleaning of the urethral area before and after insertion is essential, along with maintaining sterile technique. For intermittent catheterization, avoid reusing catheters if possible.

Reducing Discomfort: Children often have lower tolerance for catheterization discomfort. Using pre-lubricated or hydrophilic catheters can significantly reduce discomfort during insertion. For children needing long-term catheterization, regularly monitor the bladder and urethra for signs of irritation or inflammation.

Monitoring Urine Output: Regular monitoring of urine output and quality can help detect any urinary system abnormalities early. For children needing long-term catheterization, periodic assessments of urinary health are advisable.

Personalized Care: Every child's physical condition and needs vary, so catheterization plans should be tailored by physicians and caregivers according to each child’s specific condition, avoiding a one-size-fits-all approach.

Summary

The choice and usage of pediatric catheters require a comprehensive consideration of the child's age,anatomy,urinary system health,and clinical needs.Foley catheters are suitable for short-term or long-term indwelling,while intermittent catheters are ideal for short-term needs. Suprapubic catheters serve as alternatives when urethral catheterization is challenging,and neonatal catheters are specially designed for newborns. Caregivers should consider catheter size,material,and insertion technique to ensure safety and reduce the risk of infection.