Abstract
Objective:This study aims to document and analyze the central venous catheter (CVC)-related complications in children with hematological diseases who were treated within a single institution.Materials and Methods:A retrospective investigation was conducted in 106 pediatric patients in whom 203 CVCs were inserted. A total of 175 catheter-related complications occurred in 5 years.Results:The rates of clinical catheter infections, local catheter infections, venous thromboembolism, bleeding, and mechanical complications were 2.6, 1.1, 0.2, 0.2, and 0.2 per 1000 catheter days. Methicillin-resistant Staphylococcus epidermidis was the predominant infectious organism in blood and catheter cultures. The children with leukemia had a significantly higher frequency of clinical catheter infections (p=0.046). The children who underwent bone marrow transplantation had a significantly lower frequency of clinical catheter infections (p=0.043) and higher frequency of local catheter infections (p=0.003). The children with implanted catheters had a significantly lower frequency of clinical catheter infections (p=0.048). The children with thrombocytopenia had significantly fewer local catheter infections and significantly more clinical catheter infections and catheter-related bleeding (respectively p=0.001, p=0.042, and p=0.024). Conclusion:Leukemia, bone marrow transplantation, and thrombocytopenia are risk factors for CVC-associated complications. The relatively higher number of interventions performed via permanent catheters may be responsible for the significantly increased incidence of systemic infections and mechanical injury.
Highlights
Central venous catheters (CVCs) are clinical tools of the utmost importance that facilitate the administration of chemotherapy, antibiotics, blood products, fluids, and parenteral nutrition and the collection of blood samples in children with hematological diseases [1]
The present study aims to document and analyze the CVC-related complications in pediatric hematology patients who were treated within a single institution over a period of 5 years
The inclusion criteria were the diagnosis of hematological diseases and the administration of CVCs in pediatric patients aged less than 18 years at the study center between June 2003 and December 2007
Summary
Central venous catheters (CVCs) are clinical tools of the utmost importance that facilitate the administration of chemotherapy, antibiotics, blood products, fluids, and parenteral nutrition and the collection of blood samples in children with hematological diseases [1].Tunneled, cuffed, silastic CVCs were first introduced by Broviac and colleagues and were improved subsequently by Hickman and colleagues. Central venous catheters (CVCs) are clinical tools of the utmost importance that facilitate the administration of chemotherapy, antibiotics, blood products, fluids, and parenteral nutrition and the collection of blood samples in children with hematological diseases [1]. Afterwards, totally implantable vascular access devices (ports) were developed. These devices require less frequent care and provide more freedom and comfort for the patients [2,3]. Venous thromboembolism (VTE) is another serious catheter-related complication that usually appears in critically ill children [5,6]. Access-related bleeding and mechanical complications such as blockage, leakage, dislodgement, and malposition are encountered in children with catheters [7]
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