A prospective 7-year survey on central venous catheter-related complications at a single pediatric hospital

Abstract

The aims of this study were to assess the incidence and risk factors of major central venous catheter (CVC)-related complications in a large cohort of children affected by oncological, hematological, or immunological diseases in a 7-year prospective observational study at a single center. Nine hundred fifteen CVCs were inserted in 748 children for a total period of 307,846 CVC-days. Overall, 298 complications were documented with a complication rate of 0.97/1,000 CVC-days: 105 mechanical complications (dislocations 0.30/1,000 CVC-days, ruptures 0.04/1,000 CVC-days), 174 infections (bloodstream infections 0.46/1,000 CVC-days, tunnel infections 0.10/1,000 CVC-days), and 19 thrombosis (0.06/1,000 CVC-days). Significant risk factors were: diagnosis of acute lymphoblastic leukemia (ALL) and age <or=3 years for dislocations; nonmalignant disease for ruptures; ALL for thrombosis; double-lumen and partially implanted CVCs for bloodstream infections; age <or=3 years for tunnel infections. In conclusion, the rate of CVC-related complications in children was lower than that usually reported.

Complications of Central Venous Access Devices: A Systematic Review

“…These data also were not included in the review. We were unable to ascertain the number of catheter days in 23 studies, [66][67][68][69][70][71][72][73][74][75][76][77][78][79][80][81][82]84,85,92,97,99,122 which excluded their data from contributing to the meta-analysis reporting failure and complications per 1000 catheter days. Because of a lack of data, the rate of CVAD failure per 1000 catheter days for nontunneled, percutaneous CVADs could not be estimated.…”

Catheter-related bloodstream infection with removal of catheter in pediatric oncology patients: a 10-year experience in Taiwan

“…In a retrospective review of pediatric cancer patients with CVCs at another medical institution in Taiwan between 2001 and 2005, 13 out of 228 (5.7%) catheters were removed for CRBSI [8]. This indicates that the management of CRBSI in children with cancer in Taiwan after 2000 is similar to that in other developed countries [1,[5][6][7].…”

“…Although young age was not a risk factor for CRBSI in children with cancer, it was a risk factor for tunnel infections [5]. It is reported that 5-9% of CVCs had to be removed because of CRBSI in pediatric cancer patients [1,[5][6][7][8]. A recent study showed that 87% of CRBSI episodes were successfully treated with antibiotic therapy and without catheter removal in children with cancer [9].…”

“…The histology of cancer did not significantly alter the risk for CRBSI [4]. Although young age was not a risk factor for CRBSI in children with cancer, it was a risk factor for tunnel infections [5]. It is reported that 5-9% of CVCs had to be removed because of CRBSI in pediatric cancer patients [1,[5][6][7][8].…”

Vias para Nutrição Artificial na Criança (II): Acessos Parentéricos

“…17,29,[34][35][36][37][38][39][40][41] A taxa de infeção é mais alta em recém-nascidos e no caso de cateteres de múltiplo lúmen. A incidência de complicações infeciosas é substancialmente maior na NP, quer seja por PICC quer seja por CVC, com taxas até seis vezes superiores na síndroma de intestino curto devido à translocação bacteriana.…”