Risk factors for Hickman-Broviac catheter complications: An experience from a Tunisian hospital

Abstract

Background: Hickman-Broviac catheters have improved the care of young children needing frequent and prolonged venous access, but at the same times it has substantial morbidity, particularly in a resource-constrained setup. Our study aims to describe the experience of a Tunisian hospital and investigate the main risk factors for complications. Methods: In this study, we included all the neonates and infants who underwent Broviac catheter insertion in the pediatric surgery department. The patients were divided into 2 groups according to the presence of complications. We compared these two groups and univariate logistic regression analyses were used to determine the risk factors for complications. Results: Forty-three children were included in the study. The incidence of complicated catheters was 60.4%. The following factors were significantly associated with an increased risk of complications: age 6 months [OR 3.5, 95% CI: 0.6-19.3], weight 6 kg [OR 1.54, 95% CI: 0.46-5.2], emergency circumstances [OR 1.62, 95% CI: 0.8-5.4], and antibiotic-therapy as an indication for Broviac catheter insertion [OR 1.8, 95% CI: 0.5-6.2]. Conclusion: Complications seem to be more frequent in patients younger than 6 months and those with a weight of less than 6Kg. To reduce the morbidity related to the catheters, the indications should be carefully chosen.

Improvement of Broviac catheter-related outcomes after the implementation of a quality management system: A before-and-after prospective observational study

“…New protocol: Guided by the risk factors for Broviac® catheter-related morbidity [3], several actions were taken. First, all neonatal and pediatric healthcare teams were informed about the outcomes of Broviac catheters in our institution and particularly in their departments.…”

“…Sample size calculation: The sample size was calculated to be 86 (43 patients in each group) considering 60.3% the incidence of complications in a previous study in the same department [3], versus 23.03 % in the preliminary results from the data of the first 13 patients included in this study. A study sample of 43 patients in each group is required for a 95% confidence level and a 5% margin of error.…”

“…[2] In our institution, high rates of catheter-related complications were previously observed. [3] A quality process was established urgently to reduce catheterrelated morbidity through the implementation of a new protocol for patient selection and catheter management. [4] The aim of this study is to describe the new protocol of Broviac® catheters and to assess the efficacy of the main actions we have taken in enhancing our practice and improving the outcomes.…”

Complications and its risk factors of percutaneous subclavian vein catheters in pediatric patients: enhancing the outcomes of a university hospital in a low-income and middle-income country

“…Open access adequate venous access devices, the lack of experience, and nursing quality. 4 Therefore, enhancing healthcare team outcomes by assessing complications, investigating the risk factors for complications, and using an interprofessional approach with regular feedback is mandatory to reduce catheter-related morbidity. 6 The aim of this study is to assess our experience in the management of pediatric SVCs and to investigate the main risk factors for complications.…”

“…3 The type, incidence and risk factors for complications depend on the experience of the healthcare team, the indications for central line insertion and the nursing skills. 4 In high-income countries, subclavian vein catheterization is underused despite its safety because of the emergence of less invasive new devices that can save central access. 5 On the other hand, in low-income and middle-income countries, the rate of complications of central catheters can be higher because of multiple insufficiencies, such as the unavailability of ultrasounds and WHAT IS ALREADY KNOWN ON THIS TOPIC ⇒ Catheter-related complications depend on the experience of the healthcare team and nursing skills.…”