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

Bosch, Ceder H. van den; Bruggen, Jan-Tom T van der; Frakking, Florine N. J.; Scheltinga, Sheila Terwisscha van; Ven, Cornelis P. van de; Grotel, Martine van; Wellens, Lianne M.; Loeffen, Yvette G.T.; Fiocco, Marta; Wijnen, Marc H. W. A.

doi:10.1016/j.jpedsurg.2018.10.054

Cited by 39 publications

(62 citation statements)

References 33 publications

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“…We found that both adverse events and dwell period complications are common in our patient cohort, with an overall incidence of 17.4% and 25.0% respectively. The incidence of adverse events observed during catheter implantation is consistent with the 4.5%-22.0% incidence reported in prior studies of pediatric oncology patients [12][13][14]. Although ultrasound guidance has been shown to reduce the incidence of failures and inadvertent arterial punctures in pediatric central venous catheterization [15], percutaneous landmark technique was predominantly utilized in our study as this approach is traditional at our…”

Section: Discussionsupporting

confidence: 86%

Safety of tunneled central venous catheters in pediatric hematopoietic stem cell recipients with severe primary immunodeficiency diseases

Martynov¹,

Klima-Frysch²,

Kluwe³

et al. 2020

PLoS ONE

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Tunneled central venous catheters (TCVCs) provide prolonged intravenous access for pediatric patients with severe primary immunodeficiency disease (PID) undergoing hematopoietic stem cell transplantation (HSCT). However, little is known about the epidemiology and clinical significance of TCVC-related morbidity in this particular patient group. We conducted the retrospective analysis of patients with severe PID who received percutaneous landmark-guided TCVC implantation prior to HSCT. We analyzed 92 consecutive TCVC implantations in 69 patients (median [interquartile range] age 3.0 [0-11] years) with severe combined immune deficiency (n = 39, 42.4%), chronic granulomatous disease (n = 17, 18.4%), and other rare PID syndromes (n = 36, 39.2%). The median length of TCVC observation was 144.1 (85.5-194.6) days with a total of 14,040 catheter days at risk (cdr). The overall rate of adverse events during catheter insertion was 17.4% (n = 16) and 25.0% during catheter dwell period (n = 23, catheter risk [CR] per 1000 cdr = 1.64). The most common complication was TCVC-related infection with an overall prevalence of 9.8% (n = 9, CR = 0.64), followed by late dislocation (n = 6, 6.5%, CR = 0.43), early dislocation (n = 4, 4.3%) and catheter dysfunction (n = 4, 4.3%, CR = 0.28). TCVCs are safe in children with severe PID undergoing HSCT with relatively low rates of TCVC-related infection.

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Section: Discussionsupporting

confidence: 86%

Safety of tunneled central venous catheters in pediatric hematopoietic stem cell recipients with severe primary immunodeficiency diseases

Martynov¹,

Klima-Frysch²,

Kluwe³

et al. 2020

PLoS ONE

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“…[1][2][3] CVC-related bloodstream infections often result in hospital admissions for the administration of intravenous antibiotics, postponement of treatment for primary disease, early CVC removal, or intensive care unit admissions due to severe sepsis. [4] Prevention of CVC-related bloodstream infections is therefore of the utmost importance. [5,6] The use of prophylactic antimicrobial lock solutions with or without the addition of an anticoagulant have been suggested as a method for the prevention of CVC-related bloodstream infections by preventing biofilm formation, killing bacteria and/or the inhibition of bacterial growth.…”

mentioning

confidence: 99%

The efficacy of taurolidine containing lock solutions for the prevention of central-venous-catheter-related bloodstream infections: a systematic review and meta-analysis

Bosch¹,

Jeremiasse²,

Bruggen³

et al. 2022

Journal of Hospital Infection

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“…Staphylococcus aureus was cultured in 27% (14/52) of catheter-related infections in our study. This prevalence is strikingly higher than the 5.2% of S. aureus cultured during central line-associated bloodstream infection (CLABSI) episodes in a report on CVAD-related complications in pediatric oncology patients from colleagues at our institution ( 33 ). In unpublished data by Van den Bosch et al on CVAD-related complications in neuroblastoma patients, significantly more S. aureus-CLABSIs and CLABSIs overall were observed in neuroblastoma patients receiving anti-GD2 immunotherapy.…”

Section: Discussionmentioning

confidence: 69%

Treatment-Related Toxicities During Anti-GD2 Immunotherapy in High-Risk Neuroblastoma Patients

et al. 2021

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The introduction of immunotherapy using an anti-GD2 antibody (dinutuximab, ch14.18) has significantly improved survival rates for high-risk neuroblastoma patients. However, this improvement in survival is accompanied by a substantial immunotherapy-related toxicity burden. The primary objective of this study was to describe treatment-related toxicities during immunotherapy with dinutuximab, IL-2, GM-CSF, and isotretinoin. A retrospective, single center analysis of immunotherapy-related toxicities was performed in twenty-six consecutive high-risk neuroblastoma patients who received immunotherapy as maintenance therapy in the Princess Máxima Center (Utrecht, Netherlands). Toxicities were recorded and graded according to the CTCAE. Particular attention was drawn to pain and fever management and toxicities leading to dose modifications of dinutuximab and IL-2. Twenty-three patients (88%) completed all six courses of immunotherapy. Disease progression, isotretinoin-associated liver toxicity, and catheter-related infection in combination with peripheral neuropathy were reasons for immunotherapy discontinuation. The most common grade ≥3 toxicities for courses 1–5, respectively, were pain, catheter-related infections, and fever. In total, 310 grade ≥3 toxicities were recorded in 124 courses. Thirty-three grade 4 toxicities in 19/26 patients and no grade 5 toxicities (death) were seen. Fifty-nine percent of grade ≥3 toxicities were recorded in the two courses with IL-2. Catheter-related bloodstream infections were identified in 81% of patients. Four of these episodes led to intensive care admission followed by full recovery (grade 4).

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

Cited by 39 publications

References 33 publications

Safety of tunneled central venous catheters in pediatric hematopoietic stem cell recipients with severe primary immunodeficiency diseases

Safety of tunneled central venous catheters in pediatric hematopoietic stem cell recipients with severe primary immunodeficiency diseases

The efficacy of taurolidine containing lock solutions for the prevention of central-venous-catheter-related bloodstream infections: a systematic review and meta-analysis

Treatment-Related Toxicities During Anti-GD2 Immunotherapy in High-Risk Neuroblastoma Patients

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