Optimal Position of A Long-Term Central Venous Catheter Tip in A Pediatric Patient with Congenital Diseases

Caruselli, Marco; Galante, Dario; Ficcadenti, Anna; Carboni, Laura; Franco, Federica; Fabrizzi, Benedetta; Amici, Lucia; Giretti, Roberto; Rocchi, G; Rinaldelli, Giampaolo

doi:10.4081/pr.2012.e32

Cited by 7 publications

(10 citation statements)

References 18 publications

(5 reference statements)

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“…One paediatric case series suggested positioning the catheter tip in the middle right atrium for young children requiring long-term catheterization [15]. Our data do not directly refute this hypothesis; however, five lines were associated with right atrium thromboses.…”

Section: Discussioncontrasting

confidence: 71%

“…Furthermore, tip movement is a major concern for paediatric patients, especially those who are active, growing, and require long-term catheterization [15]. The purpose of this retrospective cohort study is to investigate the location and method of CVC placement as risk factors for CVC-related thrombosis, and to evaluate the extent to which catheter tip migration influences this risk.…”

Section: Introductionmentioning

confidence: 99%

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Risk factors for central venous catheter-related thrombosis in children

Chen

Agarwal

Tassone

et al. 2016

Blood Coagulation &Amp; Fibrinolysis

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Central venous catheter (CVC) placement is associated with increased risk of thrombosis in the paediatric population, particularly in relation to the type of catheter and the manner of its insertion. Here, we investigate risk factors associated with CVC-related thrombosis in children, with particular emphasis on positioning of the catheter tip. Patients aged 0-18 who underwent at least one CVC placement from 2008 to 2013 at a single centre with a subsequent follow-up echocardiogram were included for a total of 104 patients and 147 lines. Data on clinical and catheter-related risk factors were collected from patient charts. Statistical analysis using Pearson's χ tests, independent samples t-test, and odds ratios were used to assess potential risk factors for thrombosis. Neither insertion site (subclavian vein or otherwise), left- vs. right-sided insertion, nor catheter type were significant risk factors for thrombosis. There were no thrombotic events reported at the superior vena cava (SVC)-right atrium junction and no significant differences in thrombotic risk with initial tip placement in the SVC-right atrium junction vs. the SVC, right atrium, or inferior vena cava. Acute lymphoblastic leukaemia was a major clinical risk factor for thrombosis. Tip movement was common and may have been an important factor in the development of CVC-related thrombi. Prospective studies can yield insight into the role of follow-up imaging in the prevention of catheter-related thrombosis in children.

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Section: Discussioncontrasting

confidence: 71%

Section: Introductionmentioning

confidence: 99%

Risk factors for central venous catheter-related thrombosis in children

Chen

Agarwal

Tassone

et al. 2016

Blood Coagulation &Amp; Fibrinolysis

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“…In our study, we positioned the tip of the CVC just below the CA junction or the proximal RA in pediatric patients. All the pediatric patients who require long-term treatment are expected to grow taller during the treatment period and need leukapheresis (14). In addition, the diameter of the SVC in our pediatric patients was 13.7 ± 3.62 mm, similar to the diameter of the brachiocephalic vein in adult patients (15).…”

Section: Discussionmentioning

confidence: 99%

Proper Tip Position of Central Venous Catheter in Pediatric Patients

Ahn

Chung

2015

J Vasc Access

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“…While there is general agreement on the hazards of positioning a catheter deep in the right atrium, the safety of placing CVADs in the upper right atrium remains a topic of some debate 21 , 47 . ‐ 49 …”

Section: Question 5: What Factors Play a Role In Selecting And Placinmentioning

confidence: 99%

When Is Parenteral Nutrition Appropriate?

Worthington

Balint

Bechtold

et al. 2017

J Parenter Enteral Nutr

175

202

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Parenteral nutrition (PN) represents one of the most notable achievements of modern medicine, serving as a therapeutic modality for all age groups across the healthcare continuum. PN offers a life-sustaining option when intestinal failure prevents adequate oral or enteral nutrition. However, providing nutrients by vein is an expensive form of nutrition support, and serious adverse events can occur. In an effort to provide clinical guidance regarding PN therapy, the Board of Directors of the American Society for Parenteral and Enteral Nutrition (ASPEN) convened a task force to develop consensus recommendations regarding appropriate PN use. The recommendations contained in this document aim to delineate appropriate PN use and promote clinical benefits while minimizing the risks associated with the therapy. These consensus recommendations build on previous ASPEN clinical guidelines and consensus recommendations for PN safety. They are intended to guide evidence-based decisions regarding appropriate PN use for organizations and individual professionals, including physicians, nurses, dietitians, pharmacists, and other clinicians involved in providing PN. They not only support decisions related to initiating and managing PN but also serve as a guide for developing quality monitoring tools for PN and for identifying areas for further research. Finally, the recommendations contained within the document are also designed to inform decisions made by additional stakeholders, such as policy makers and third-party payers, by providing current perspectives regarding the use of PN in a variety of healthcare settings. (JPEN J Parenter Enteral Nutr. 2017;41:324-377) The etiology-based nutrition diagnoses in adults in clinical practice settings are as follows: Starvation-related malnutrition: Chronic starvation without inflammation (eg, anorexia nervosa). Chronic disease-related malnutrition: Inflammation is chronicand of mild to moderate degree (eg, organ failure, pancreatic cancer, rheumatoid arthritis, sarcopenic obesity). Acute disease or injury-related malnutrition:Inflammation is acute and of severe degree (eg, major infection burns, trauma, closed head injury). 2,3Malnutrition, pediatric: An imbalance between nutrient requirement and intake, resulting in cumulative deficits of energy, protein, or micronutrients that may negatively affect growth, development, and other relevant outcomes. It is recommended that growth charts based on a standard deviation z score system be used to track and assess nutrition status in children. 4,5Nutritionally-at-risk: Consider the individual nutritionally-atrisk if any of the following is present. Nutritionally-At-Risk Adult Summary of RecommendationsThese consensus recommendations are designed to identify best practices, guide day-to-day clinical decisions, reduce variations in practice, and enhance patient safety. They are not intended to supersede the judgment of the healthcare professional based on the circumstances of the individual patient.

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Optimal Position of A Long-Term Central Venous Catheter Tip in A Pediatric Patient with Congenital Diseases

Cited by 7 publications

References 18 publications

Risk factors for central venous catheter-related thrombosis in children

Risk factors for central venous catheter-related thrombosis in children

Proper Tip Position of Central Venous Catheter in Pediatric Patients

When Is Parenteral Nutrition Appropriate?

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