Medium and long term central venous access in children

Area of Science:

• Pediatric Medicine
• Vascular Access Devices
• Infectious Disease Control

Background:

• Central venous access devices (CVAD) are crucial for managing critically ill children.
• Standardized protocols are essential for safe CVAD insertion and management in pediatric populations.

Purpose of the Study:

• To evaluate the safety and feasibility of central venous access device (CVAD) insertion in a pediatric cohort.
• To identify risk factors for insertion-related complications and catheter-associated infections (CAI) in children.

Main Methods:

• A uniform protocol governed the insertion of 104 central venous access devices (CVAD) in 91 pediatric patients.
• Data collected included patient demographics, insertion circumstances (planned vs. emergency), complications, and catheter dwell time.

Main Results:

• Twelve minor insertion-related complications occurred, with higher risk in neonates and bedside insertions.
• Non-infectious complications occurred in 20% of cases, influenced by age and insertion site (femoral route safest).
• Catheter-associated infections (CAI) incidence was 15.4%, with neonates at higher risk; only 2 cases of catheter-associated bloodstream infection were reported.

Conclusions:

• Central venous access device (CVAD) use is feasible and safe in pediatric patients, particularly neonates and infants.
• Risk factors for complications include neonatal age and emergency bedside insertion.
• Careful consideration of age, insertion site, and potential complications can optimize catheter duration.