Implantable versus cuffed external central venous catheters for the management of children and adolescents with acute lymphoblastic leukaemia

White, Alan; Othman, Diaa; Dawrant, Michael J.; Sohrabi, Soroush; Young, Alastair L.; Squire, Roly

doi:10.1007/s00383-012-3213-4

Cited by 12 publications

(19 citation statements)

References 18 publications

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“…Twelve studies 59,61,66,67,72,76,82,83,89,97,105,121 described the outcome of CVADassociated BSI without the clarity and rigor of benchmarked standards, which meant that their CVAD-associated BSI data were not included in the review. Two studies 30,116 provided combined "all-type" infection or mechanical failure outcomes, instead of providing separated local and systemic infection, occlusion, and dislodgement data.…”

Section: Study Qualitiesmentioning

confidence: 99%

“…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.…”

Section: Study Qualitiesmentioning

confidence: 99%

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Complications of Central Venous Access Devices: A Systematic Review

et al. 2015

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CONTEXT: The failure and complications of central venous access devices (CVADs) result in interrupted medical treatment, morbidity, and mortality for the patient. The resulting insertion of a new CVAD further contributes to risk and consumes extra resources.OBJECTIVE: To systematically review existing evidence of the incidence of CVAD failure and complications across CVAD types within pediatrics.DATA SOURCES: Central Register of Controlled Trials, PubMed, and Cumulative Index to Nursing and Allied Health databases were systematically searched up to January 2015.STUDY SELECTION: Included studies were of cohort design and examined the incidence of CVAD failure and complications across CVAD type in pediatrics within the last 10 years. CVAD failure was defined as CVAD loss of function before the completion of necessary treatment, and complications were defined as CVAD-associated bloodstream infection, CVAD local infection, dislodgement, occlusion, thrombosis, and breakage. CONCLUSIONS: CVAD failure and complications in pediatrics are a significant burden on the health care system internationally.

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Section: Study Qualitiesmentioning

confidence: 99%

Section: Study Qualitiesmentioning

confidence: 99%

Complications of Central Venous Access Devices: A Systematic Review

et al. 2015

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“…Since lumen diameter and number corresponded with the CVAD-type, these were also excluded in the multivariate analyses. Disease severity of the underlying malignancy and the associated longer neutropenia episodes have been associated with the incidence of, and removal owing to CLABSI [16,22,28]. Disease severity was therefore investigated by scoring the presence of severe neutropenia, a neutrophil granulocyte count of less than 100 × 106 /L, during CLABSI in the HB-CVAD group compared to the TIVAP group.…”

Section: Definitions and Outcome Measurementsmentioning

confidence: 99%

Incidence, severity and outcome of central line related complications in pediatric oncology patients; A single center study

Bosch

Bruggen

Frakking

et al. 2019

Journal of Pediatric Surgery

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Background: Central venous access device (CVAD)-related complications are associated with high morbidity rates. This study was performed to underline the importance of CVAD-complication prevention and treatment. Methods: An audit of practice of CVAD-related complications in pediatric oncology patients receiving a CVAD between January 2015 and June 2017 was performed. CVADs included were totally implantable venous access ports (TIVAPs), Hickman-Broviac® (HB), nontunneled, and peripherally inserted CVADs. Results: A total of 201 children, with 307 CVADs, were analyzed. The incidence rates per 1000 CVAD-days for the most common complications were 1.66 for malfunctions, and 1.51 for central line-associated bloodstream infections (CLABSIs). Of all CVADs inserted, 37.1% were removed owing to complications, of which 45.6% were owing to CLABSIs. In 42% of the CLABSIs, the CLABSI could be successfully cured with systemic antibiotic treatment only. Of all included patients, 5.0% were admitted to the intensive care unit owing to CLABSI. The HB-CVAD compared to the TIVAP was a risk factor for CVAD-related complications, CLABSIs and dislocations in particular. Conclusions: The incidence of CVAD-related complications is high. Research on the prevention and treatment of CVAD-related complications in pediatric oncology patients should be a high priority for all health care professionals. Type of study: Prognosis study (retrospective).

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“…This finding was in keeping with a meta‐analysis of adult studies that identified a higher rate of thrombosis in PICC lines, particularly in adults who were critically ill or had malignancy (Chopra et al , ), although more recent data in adults have shown a lower risk of thrombosis compared with traditional CVLs in a population with acute leukaemia (Cerchione et al , ). Thrombosis occurs less frequently in association with internal lines (ports) than external tunnelled lines, such as Hickman or Broviac catheters (McClean et al , ; White et al , ; Mangum et al , ). A multicentre randomised controlled trial (RCT) in adults with malignancy, comparing complication rates between external tunnelled lines, ports and PICCs for the administration of chemotherapy, is currently ongoing [Cancer and Venous Access (CAVA); ISRCTN 44504648].…”

Section: Reducing the Risk Of Vtementioning

confidence: 99%

BSH Guideline: management of thrombotic and haemostatic issues in paediatric malignancy

et al. 2018

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Implantable versus cuffed external central venous catheters for the management of children and adolescents with acute lymphoblastic leukaemia

Abstract: When patients are risk-stratified for disease severity there is no difference in rates of CVC removal prior to completion of treatment.

Cited by 12 publications

References 18 publications

Complications of Central Venous Access Devices: A Systematic Review

Complications of Central Venous Access Devices: A Systematic Review

Incidence, severity and outcome of central line related complications in pediatric oncology patients; A single center study

BSH Guideline: management of thrombotic and haemostatic issues in paediatric malignancy

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