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Related Experiment Videos

Vascular access.

S J Holmes1, E M Kiely, L Spitz

  • 1Hospital for Sick Children, London, UK.

Progress in Pediatric Surgery
|January 1, 1989
PubMed
Summary
This summary is machine-generated.

Tunnelled central venous catheters lasted four times longer and were less likely to cause infection compared to non-tunnelled catheters in patients undergoing chemotherapy. This highlights improved vascular access for cancer patients.

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Area of Science:

  • Vascular Surgery
  • Oncology
  • Infectious Diseases

Background:

  • Central venous catheters (CVCs) are crucial for chemotherapy delivery.
  • Vascular access complications, including infection and sepsis, are significant challenges in cancer patients.
  • Previous methods of CVC insertion had limitations regarding longevity and infection rates.

Purpose of the Study:

  • To compare the efficacy and safety of tunnelled versus non-tunnelled central venous catheters.
  • To evaluate the impact of CVC type on infection rates and catheter dwell time.
  • To assess the role of vascular access in managing pediatric cancer patients.

Main Methods:

  • Retrospective survey analyzing data on central venous catheter use.
  • Comparison of outcomes between tunnelled and directly inserted CVCs.

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  • Review of complications, including infection, sepsis, thrombosis, and cardiac issues.

    • Main Results:

    • Tunnelled CVCs demonstrated four times longer indwelling duration than directly inserted CVCs.
    • Directly inserted CVCs were associated with a four-fold increase in infection risk.
    • One-third of all catheters were removed due to presumed infection, often linked to sepsis in chemotherapy patients.
    • No insertion-related complications were reported with direct central vein exposure.
    • Long-term atrial catheters showed no significant association with venous thrombosis or cardiac complications.

    Conclusions:

    • Tunnelled central venous catheters offer superior longevity and reduced infection risk compared to non-tunnelled CVCs.
    • Effective vascular access management is vital for pediatric cancer patient care, despite high infection rates.
    • Specialized nursing care and psychosocial support are essential for mitigating challenges with long-term CVCs.