TY - JOUR
T1 - A single institution observational study of early mechanical complications in central venous catheters (valved and open-ended) in children with cancer
AU - Fratino, Giuseppe
AU - Castagnola, Elio
AU - Carlini, Claudio
AU - Mazzola, Cinzia
AU - Jasonni, Vincenzo
AU - Molinari, Angelo Claudio
AU - Haupt, Riccardo
PY - 2004/9
Y1 - 2004/9
N2 - The use of indwelling central venous catheters (CVCs) has become essential for managing children undergoing cancer treatment. Various types of CVCs are available, but reports on complications observed in pediatric series are scarce. We describe our experience concerning early mechanical complications at our institute by providing a prospective evaluation of three types of CVCs that were inserted over a 39-month period. Between January 1, 2000, and March 31, 2003, double-lumen (DL) or single-lumen (SL) Hickman-Broviac (HB) and single-lumen pressure-activated safety-valved (PASV) catheters were inserted and prospectively evaluated. Five groups of possible mechanical complications were defined a priori: dislodgement, migration, rupture, accidental removal, and blockage. We took into consideration complications occurring only within the first 30 days of insertion. A total of 272 CVCs (118 PASV, 57 DL-HB, and 97 SL-HB) were inserted in 232 children. A total of 29 early mechanical complications (10.7% of all CVCs) were diagnosed: 15.2% of the PASV, 10.5% of the DL-HB, and 4.1% of the SL-HB. Elective removal of the catheter due to complications was required in eight patients. SL-HB catheters had fewer complications, while the complication rate and the number of devices that were removed were significantly higher in patients with PASV catheters. We conclude that catheter type correlates with the risk of early mechanical complications and removal.
AB - The use of indwelling central venous catheters (CVCs) has become essential for managing children undergoing cancer treatment. Various types of CVCs are available, but reports on complications observed in pediatric series are scarce. We describe our experience concerning early mechanical complications at our institute by providing a prospective evaluation of three types of CVCs that were inserted over a 39-month period. Between January 1, 2000, and March 31, 2003, double-lumen (DL) or single-lumen (SL) Hickman-Broviac (HB) and single-lumen pressure-activated safety-valved (PASV) catheters were inserted and prospectively evaluated. Five groups of possible mechanical complications were defined a priori: dislodgement, migration, rupture, accidental removal, and blockage. We took into consideration complications occurring only within the first 30 days of insertion. A total of 272 CVCs (118 PASV, 57 DL-HB, and 97 SL-HB) were inserted in 232 children. A total of 29 early mechanical complications (10.7% of all CVCs) were diagnosed: 15.2% of the PASV, 10.5% of the DL-HB, and 4.1% of the SL-HB. Elective removal of the catheter due to complications was required in eight patients. SL-HB catheters had fewer complications, while the complication rate and the number of devices that were removed were significantly higher in patients with PASV catheters. We conclude that catheter type correlates with the risk of early mechanical complications and removal.
KW - Central venous catheters
KW - Children
KW - Early mechanical complications
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U2 - 10.1007/s00383-004-1279-3
DO - 10.1007/s00383-004-1279-3
M3 - Article
C2 - 15449084
AN - SCOPUS:7644231589
VL - 20
SP - 704
EP - 707
JO - Pediatric Surgery International
JF - Pediatric Surgery International
SN - 0179-0358
IS - 9
ER -