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Mechanical complications during central venous cannulations in pediatric patients

Corsino Rey1, Francisco Alvarez, Victoria De La Rua

  • 1Paediatric Intensive Care Unit, Department of Paediatrics, Hospital Universitario Central de Asturias, University of Oviedo, Celestino Villamil s/n 33006, Asturias, Oviedo, Spain. corsino.rey@sespa.princast.es

Intensive Care Medicine
|June 17, 2009
PubMed

Insights

Early mechanical complications (EMC) of central venous catheterizations (CVC) are common in pediatric intensive care, but severe events are rare. Resident CVC failure, high venous access, and multiple attempts increase EMC risk.

Area of Science:

  • Pediatric critical care medicine
  • Vascular access procedures
  • Patient safety in healthcare

Background:

  • Central venous catheterizations (CVCs) are essential in pediatric intensive care units (PICUs).
  • Early mechanical complications (EMCs) can arise during CVC placement.
  • Identifying risk factors for EMCs is crucial for improving patient safety.

Purpose of the Study:

  • To identify the incidence of early mechanical complications (EMCs) associated with central venous catheterizations (CVCs) in pediatric patients.
  • To determine independent risk factors contributing to EMCs during CVC placement in a pediatric intensive care setting.

Main Methods:

  • A prospective observational study was conducted in a university hospital's pediatric intensive-care unit.
  • Data on 825 CVCs in 546 patients were collected, including patient demographics, procedure details, catheter characteristics, and EMC occurrence.
  • Multivariate analysis was employed to identify independent risk factors for EMCs.

Main Results:

  • The overall incidence of EMCs was 17.5% (151/144 CVCs), with arterial puncture (7.2%) and catheter malposition (4.7%) being the most frequent.
  • Independent risk factors for EMCs included resident CVC failure (OR 2.53), use of high venous access sites like subclavian or jugular (OR 1.91), and an increased number of attempts (OR 1.10).
  • While EMCs were common, severe complications were infrequent.

Conclusions:

  • Early mechanical complications of CVCs are frequent in pediatric teaching hospital settings.
  • Resident CVC failure, preference for high venous access, and a higher number of insertion attempts are significant independent risk factors for EMCs.
  • Focusing on these risk factors can help reduce CVC-related complications in pediatric patients.
Abstract

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