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Central venous catheter repair is highly successful in children with intestinal failure
Alvin P Chan1, Pamela S Baldivia2, Laurie E Reyen2
1Department of Pediatrics, David Geffen School of Medicine at UCLA, Los Angeles, CA.
Insights
Central venous catheter (CVC) repair in children with intestinal failure is highly successful. This procedure effectively restores catheter function with a low risk of central line-associated bloodstream infections (CLABSIs).
Area of Science:
- Pediatric Gastroenterology
- Vascular Access Management
- Infectious Disease Prevention
Background:
- Central venous catheters (CVCs) are vital for parenteral nutrition (PN) in children with intestinal failure (IF).
- CVC repair is often performed to maintain vascular access and avoid replacement.
- Concerns exist regarding potential increased risk of central line-associated bloodstream infections (CLABSIs) after CVC repair.
Purpose of the Study:
- To evaluate the outcomes of CVC repairs in pediatric patients with IF.
- To determine the success rate of CVC repairs.
- To assess the incidence of CLABSIs following CVC repair procedures.
Main Methods:
- Retrospective review of pediatric IF patients on home PN for over 6 months.
- Analysis of CVC repair success and post-repair CLABSI rates over a 2-year period.
- Descriptive statistics including medians and frequencies were used.
Main Results:
- 96 CVC repairs were performed on 36 pediatric IF patients.
- 98% of CVC repairs were successful, restoring catheter function.
- A single CLABSI (1%) occurred post-repair in an immunocompromised patient.
Conclusions:
- CVC repair is a highly successful intervention for pediatric patients with IF.
- The risk of CLABSI following CVC repair is low.
- Catheter repair should be considered to prolong catheter lifespan and preserve vascular access.
Purpose:
Damaged central venous catheters (CVCs) are commonly repaired to avoid line replacement and preserve vascular access. However, limited data suggest an increased risk for central line-associated bloodstream infections (CLABSIs) associated with the repair procedure. The purpose of this study was to describe outcomes of CVC repairs among parenteral nutrition (PN) dependent children with intestinal failure (IF).
Methods:
A 2-year retrospective review was performed on children with IF on home PN > 6 months. Outcomes of interest were repair success and postrepair CLABSI incidence. Descriptive statistics included medians and frequencies.
Results:
A total of 36 pediatric IF patients underwent 96 CVC repairs during the study period. The median CVC repair count was 1.5 repairs/patient (range, 1 to 16 repairs/patient) with >1 repair in half the patients. Ninety-four broken catheters (98%) were successfully repaired with restoration of function. Of the unsuccessful repairs (2%), the two catheters eventually required surgical removal and replacement. One repair (1%) was followed by a CLABSI with Enterococcus faecalis in an immunocompromised patient.
Conclusion:
CVC repair is a highly successful procedure with a low risk for infection. Catheter repair should be considered whenever possible as it may extend the lifetime of the catheter and decrease the risk for vascular access loss.
Level Of Evidence:
Treatment study; level IV.
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