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Cuff Cath: an initial experience of cuffed polyurethane central venous catheters in children
1Wessex Regional Centre for Paediatric Surgery, General Hospital, Southampton, United Kingdom.
Insights
Polyurethane central venous catheters (CVCs) show promise in children, with fewer blockages and displacements than silicone CVCs. This study highlights their potential as a safer alternative for long-term use.
Area of Science:
- Pediatric medicine
- Biomaterials science
- Medical device engineering
Background:
- Silicone central venous catheters (CVCs) often face issues like blockage, fracture, and displacement.
- Polyurethane offers a smoother, stronger alternative material for CVCs.
Purpose of the Study:
- To prospectively evaluate the safety and efficacy of polyurethane cuffed CVCs (Cuff Cath) in pediatric patients.
- To compare the performance of polyurethane CVCs against historical data of silicone CVCs.
Main Methods:
- A prospective study involving 60 tunnelled polyurethane CVCs (Cuff Cath) in 53 pediatric patients.
- Catheters were inserted via subclavian or internal jugular veins.
- Data collected on catheter dwell time, complications, and functionality.
Main Results:
- A total of 6363 catheter days were analyzed.
- Only 5% of CVCs were removed due to sepsis and 2% due to blockage.
- No instances of catheter fracture, dislodgement, or migration were reported.
Conclusions:
- Polyurethane cuffed CVCs demonstrate significant advantages over silicone CVCs in pediatric patients, particularly regarding reduced blockage, fragmentation, and dislodgement.
- Further randomized controlled trials are needed to directly compare polyurethane and silicone CVCs in children.
Abstract:
The tendency of medium- and long-term silicone central venous catheters (CVCs) to block, fracture, and become displaced has led to the evaluation of a polyurethane CVC, Cuff Cath (Viggo Spectramed, Swindon, Wilts, United Kingdom) as a possible alternative because polyurethane is smoother and stronger. We report the first prospective study of polyurethane cuffed CVCs in children. Sixty Cuff Caths were placed in 53 children, mean age 4.7 years (range, 4 days to 16.3 years), mean weight 15.6 kg (range, 3.1 to 58 kg). All CVCs were tunnelled (mean tunnel length, 12 cm; range, 5 to 20 cm) and inserted either into the subclavian vein (n = 28) or internal jugular vein (n = 32). In a total of 6363 catheter days (mean, 111 days per patient; range, 15 to 364 days), three (5%) CVCs had to be removed because of sepsis and one (2%) because of blockage. All other Cuff Caths remained patent to infusion and blood sampling. No Cuff Caths were pulled or fell out, fractured, or migrated. This study demonstrates significant advantages of polyurethane compared with previous series using silicone CVCs with respect to blockage, fragmentation, and dislodgement. A prospective, randomized, controlled trial of Cuff Cath compared with a silicone CVCs in children is required.