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Central venous catheter placement in children with thrombocytopenia

Claudio Olivieri1, Alessandro Crocoli, Maria D De Pasquale

  • 1Division of Pediatric, General and Thoracic Surgery, Bambino Gesù Children's Hospital, Rome, Italy - claudioolivieri@libero.it.

Minerva Pediatrica
|March 19, 2015
PubMed

Insights

Central venous catheter (CVC) placement is safe in children with thrombocytopenia. Bleeding complications were minimal (8%) even in those with low platelet counts, suggesting prophylactic transfusions may not always be necessary.

Area of Science:

  • Pediatric Hematology
  • Vascular Access Procedures
  • Hemostasis and Thrombosis

Background:

  • Central venous catheters (CVCs) are vital for chronically ill children.
  • Thrombocytopenia increases bleeding risk during CVC insertion.
  • Guidelines for CVC placement in patients with hemostatic disorders are lacking, and prophylactic platelet transfusions are debated.

Purpose of the Study:

  • To evaluate the bleeding risk associated with CVC placement in pediatric patients with thrombocytopenia.

Main Methods:

  • A retrospective single-center study analyzed 72 CVC insertions over two years.
  • Patients were divided into two groups based on platelet (PLT) count: below 50×10^9/L (Group A) and above (Group B).
  • Hematological values and post-operative bleeding complications were compared.

Main Results:

  • 25 patients (Group A) received prophylactic PLT transfusions before CVC placement.
  • Only two bleeding complications (8%) were reported in Group A.
  • No significant difference in bleeding was highlighted between groups.

Conclusions:

  • Central venous catheter placement is safe in pediatric patients with thrombocytopenia.
  • Further randomized multicenter studies are needed to confirm the benefit of prophylactic platelet transfusions for platelet counts below 50×10^9/L.
Abstract

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