Abstract

Central venous access is one of the most common surgery procedures worldwide, especially in pediatric surgery. Local and regional complications as the result of venous catheter permanence time are frequently described as: thrombosis, infection, edema and local cellulite, movement and loss of the catheter. Other severe complications such as endocardiac and hemorrhagic lesions are also described and considered the cause of catheter early removal. In the literature few studies have addressed vascular and perivascular lesions and complications as the result of central venous access to peripheral veins, given the difficulty of setting up venous catheterization experimental models to study blood vessels and perivascular tissue alterations after catheterization. In the present venous catheterization experimental model, rabbits were divided into two groups based on the time that the venous catheters were maintained in their veins. Group a composed of 7 New Zealand male rabbits was submitted to a 15-day treatment; and the 6 New Zealand male rabbits of group B were treated during 90 days. Both groups presented similar inflammatory conditions since there was no significant difference between groups. Therefore, the results may well suggest that the endothelial inflammatory reaction could have developed at an early initial short period and by maintaining the catheter, the inflammatory reactions would have decreased or disappeared. Aimed at studying these vascular and perivascular alterations in venous catheterization, the present study proposes an experimental rabbit model that allows the analysis of differences in local vascular and perivascular histological variations and compares histological differences between both venous catheterization groups each of them with different periods of treatment.

Highlights

  • Despite high complication rates, central venous access is largely used in neonatal and pediatric and neonatal intensive care units and several surgical procedures [1] [2]

  • Endothelial lesion, venous stasis, and blood hypercoagulability characterize Virchow triad (1856) that results in thrombophlebitis and deep vein thrombosis (DVT)

  • The objective of the current study is to present an experimental venous catheterization model in rabbits that allows the analysis of alterations in vascular and perivascular veins with catheters of polyethetraflurethylene (PTFE) 17 GA by comparing two groups with different catheter permanence time

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Summary

Introduction

Central venous access is largely used in neonatal and pediatric and neonatal intensive care units and several surgical procedures [1] [2]. Several complications have been described, at the moment of the catheter insertion procedure, and for the period of time it is inserted in the vein and at its removal [5]. Lesions such as venous laceration, dissection of the venous wall and accidental arterial puncture, pneumothorax, hematoma, and even death were described as complications during the catheter introduction procedure [6]. When venous catheters are utilized, endothelial lesions and venous stasis are the factors that start the thrombotic process [7] [8]. Inducers of endothelial adhesive molecules, interleukin-1 (IL-1), and tumor necrosis factor (TNF) are essential for the adhesion of leucocytes to the endothelium surface before they move to adjacent tissues [8] [9]

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