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Long-term central venous access in a pediatric leukemia population
Aurelia B Fu1, Erica I Hodgman2, Lorraine S Burkhalter1
1Division of Pediatric Surgery, Children's Health, Dallas, Texas.
The Journal of Surgical Research
|September 25, 2016
Summary
Obesity, packed red blood cell dosage, and bloodstream infections increase premature central venous access device (CVAD) removal risk in pediatric leukemia. Unexplained malfunction lowers this risk, guiding better CVAD management.
Area of Science:
- Pediatric Oncology
- Hematology
- Medical Devices
Background:
- Central venous access devices (CVADs) are crucial for pediatric oncology patients.
- CVADs are linked to significant complication rates.
- Identifying risk factors for premature CVAD removal is essential.
Purpose of the Study:
- To identify risk factors for premature removal of central venous access devices (CVADs) in pediatric leukemia patients.
- To investigate if disease-specific factors in acute lymphoblastic leukemia and acute myelogenous leukemia influence CVAD longevity.
Main Methods:
- Retrospective study of leukemia patients from May 2009 to July 2014.
- Analysis of clinical characteristics and procedure records.
- Statistical analysis to determine risk factors for premature CVAD removal.
Main Results:
- Perioperative complication rate was 6%.
- Over 70% of CVADs experienced long-term complications.
- Obesity (OR 6.9), packed red blood cell dosage (OR 3.13), and bloodstream infection (OR 5.75) increased premature removal risk.
- Unexplained malfunction was associated with lower risk (OR 0.28).
Conclusions:
- Obesity, preoperative packed red blood cell dosage, and bloodstream infections are significant predictors of premature CVAD removal in pediatric leukemia.
- Unexplained line malfunction is associated with a lower risk of premature removal.
- Findings can inform strategies to optimize CVAD management in this vulnerable population.
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