Retrospective Assessment of Patient and Catheter Characteristics Associated With Malpositioned Central Venous Catheters in Pediatric Patients

2022 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Mark D. Weber ◽  
Thomas Conlon ◽  
Charlotte Woods-Hill ◽  
Stephanie L. Watts ◽  
Eileen Nelson ◽  
...  
Keyword(s):  
Pediatric Patients ◽  
Central Venous Catheters ◽  
Central Venous ◽  
Retrospective Assessment

scholarly journals Risk factors for unplanned removal of central venous catheters in hospitalized children with hematological and oncological disorders

2020 ◽  
Author(s):  
Moe Miyagishima ◽  
Hamada Motoharu ◽  
Yuji Hirayama ◽  
Hideki Muramatsu ◽  
Takahisa Tainaka ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cumulative Incidence ◽  
Pediatric Patients ◽  
Cohort Analysis ◽  
Multivariable Analysis ◽  
Central Line ◽  
Central Venous Catheters ◽  
Central Venous ◽  
Subdistribution Hazard ◽  
Significant Difference

Background: Central venous catheters (CVCs) have been essential devices for the treatment of children with hematological and oncological disorders. Only few studies investigated the complications and selections of different types of CVCs in these pediatric patients. This study aimed to compare risk factors for unplanned removal of two commonly used CVCs, i.e., peripherally inserted central catheters (PICCs) and tunneled CVCs, and propose better device selection for the patient. Procedure: This retrospective, single center cohort analysis was conducted on pediatric patients with hematological and oncological disorders inserted with either a PICC or a tunneled CVC. Results: Between January 1, 2013, and December 31, 2015, 89 patients inserted with tunneled CVCs (total 21,395 catheter-days) and 84 with PICCs (total 9,177 catheter-days) were followed up until the catheter removal. The median duration of catheterization was 88 days in PICCs and 186 days in tunneled CVCs (p = 1.24×10-9). PICCs at the 3-month cumulative incidence of catheter occlusion (5.2% vs. 0%, p = 4.08×10-3) and total unplanned removal (29.0% vs 7.0%, p = 0.0316) were significantly higher, whereas no significant difference was observed in the cumulative incidence of central line-associated bloodstream infection (11.8% vs. 2.3%, p = 0.664). Multivariable analysis identified younger age (<2 years) (subdistribution hazard ratio [SHR], 2.29; 95% confidence interval [CI], 1.27–4.14) and PICCs (SHR, 2.73; 95% CI, 1.48–5.02) were independent risk factors for unplanned removal. Conclusion: Our results suggest that tunnel CVCs would be a preferred device for children with hematological and oncological disorders requiring long-term, intensive treatment.

Transhepatic Central Venous Catheters in Pediatric Patients With Congenital Heart Disease

2015 ◽  
Vol 16 (8) ◽  
pp. 726-732 ◽  
Author(s):  
Brian A. Boe ◽  
Jeffrey D. Zampi ◽  
Sunkyung Yu ◽  
Janet E. Donohue ◽  
Ranjit Aiyagari
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Heart ◽  
Pediatric Patients ◽  
Central Venous Catheters ◽  
Central Venous

Pediatric Central Venous Catheter Management: A Review of Current Practice

2013 ◽  
Vol 18 (2) ◽  
pp. 93-98 ◽  
Author(s):  
Mary Beth Hovda Davis
Keyword(s):  
Current Practice ◽  
Pediatric Patients ◽  
Venous Catheter ◽  
Central Venous Catheters ◽  
Common Complication ◽  
Successful Therapy ◽  
Central Venous ◽  
Vessel Size ◽  
Intravenous Treatment ◽  
Pediatric Populations

Abstract Due to small vessel size, obtaining stable access in pediatric patients is difficult. In addition, because needle stick pain is a concern for patients with chronic illness, central venous catheters are often utilized to provide intravenous treatment. Catheter occlusion is a common complication in pediatric patients and must be addressed to salvage the catheter and ensure successful therapy. The use of fibrinolytics for occlusion treatment have been successful in pediatric populations.

Use of peripherally inserted central venous catheters (PICCs) in children receiving autologous or allogeneic stem-cell transplantation

2018 ◽  
Vol 19 (2) ◽  
pp. 131-136 ◽  
Author(s):  
Stefano Benvenuti ◽  
Rosanna Ceresoli ◽  
Giovanni Boroni ◽  
Filippo Parolini ◽  
Fulvio Porta ◽  
...  
Keyword(s):  
Stem Cell ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Allogeneic Stem Cell Transplantation ◽  
Pediatric Patients ◽  
Marrow Transplant ◽  
Central Venous Catheters ◽  
Cell Transplant ◽  
Central Venous ◽  
Allogenic Blood

Introduction: The aim of our study was to present our experience with the use of peripherally inserted central catheters (PICCs) in pediatric patients receiving autologous or allogenic blood stem-cell transplantation. The insertion of the device in older children does not require general anesthesia and does not require a surgical procedure. Methods: From January 2014 to January 2017, 13 PICCs were inserted as a central venous device in 11 pediatric patients submitted to 14 autologous or allogeneic stem-cell transplantation, at the Bone Marrow Transplant Unit of the Children’s Hospital of Brescia. The mean age of patients at the time of the procedure was 11.3 years (range 3-18 years). PICCs remained in place for an overall period of 4104 days. All PICCs were positioned by the same specifically trained physician and utilized by nurses of our stem-cell transplant unit. Results: No insertion-related complications were observed. Late complications were catheter ruptures and line occlusions (1.2 per 1000 PICC days). No rupture or occlusion required removal of the device. No catheter-related venous thrombosis, catheter-related bloodstream infection (CRBSI), accidental removal or permanent lumen occlusion were observed. Indications for catheter removal were completion of therapy (8 patients) and death (2 patients). Three PICCs are currently being used for blood sampling in follow-up patients after transplantation. Conclusions: Our data suggest that PICCs are a safe and effective alternative to conventional central venous catheters even in pediatric patients with high risk of infectious and hemorrhagic complications such as patients receiving stem-cell transplantation.

Prospective, Randomized Trial of Two Different Modalities of Flushing Central Venous Catheters in Pediatric Patients With Cancer

2009 ◽  
Vol 27 (12) ◽  
pp. 2059-2065 ◽  
Author(s):  
Simone Cesaro ◽  
Gloria Tridello ◽  
Mara Cavaliere ◽  
Laura Magagna ◽  
Patrizia Gavin ◽  
...  
Keyword(s):  
Normal Saline ◽  
Complication Rate ◽  
Pediatric Patients ◽  
Central Venous Catheters ◽  
Positive Pressure ◽  
Cumulative Probability ◽  
Central Venous ◽  
Patients With Cancer ◽  
Heparin Solution ◽  
Premature Removal

Purpose There are limited prospective data on whether the method of flushing affects the complication rate of tunnelled central venous catheters (CVCs). Patients and Methods During a 25-month period, 203 pediatric patients who had newly placed Broviac-Hickman CVCs were randomly assigned to standard flushing with heparin solution or to experimental flushing with normal saline via a positive-pressure cap. Results Two hundred twenty-one complications were recorded among 75,249 CVC-days (2.94 per 1,000 CVC-days). A higher incidence of CVC occlusion (83 v 41 episodes; P = .0002) and bacteremia (24 v 9; P = .01) were found in the experimental arm. The cumulative probability of developing at least one CVC complication was higher in the experimental arm than in the standard arm (65.1% [95% CI, 55% to 75%] v 43.8% [95% CI, 34% to 54%], respectively; P = .01). No difference was found in either the cause or the frequency of premature removal of CVCs between the two study arms. After a median follow-up of 360 days (range, 4 to 1,073), CVC survival was similar: 77% (95% CI, 66% to 84%) for the experimental arm and 69% (95% CI, 53% to 80%) for the standard arm (P = .7). The factors associated with the occurrence of CVC complication were a diagnosis of leukemia/lymphoma, double-lumen CVC, and experimental flushing. The only factor significantly associated with premature removal of a CVC was a diagnosis of leukemia/lymphoma (hazard rate, 2.3; 95% CI, 1.1 to 4.7). Conclusion An increased complication rate was found with normal saline flushing, but additional investigation is warranted to clarify whether it is related to saline use or to once-a-week flushing.

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