Fractured pediatric central venous catheters - Repair or replace?

Area of Science:

• Pediatric Surgery
• Vascular Access Devices
• Medical Complications

Background:

• Central venous catheter (CVC) fracture is a frequent complication in pediatric patients.
• Understanding risk factors and treatment outcomes is crucial for managing CVC complications.

Purpose of the Study:

• To identify risk factors associated with central venous catheter (CVC) fracture in children.
• To compare the outcomes of CVC repair versus CVC replacement in pediatric patients.

Main Methods:

• Retrospective cohort study of children with tunneled CVCs from 2000 to 2016.
• Comparison of fractured CVCs to non-fractured CVCs to determine risk factors.
• Analysis of outcomes for CVC repair versus replacement, including durability and CVC-associated bloodstream infections (CLABSI).

Main Results:

• The CVC fracture rate was 29.2% in 236 children.
• Fractures were more common with double lumen CVCs and for total parenteral nutrition indications.
• CVC replacement showed longer durability (181.98 days) than repair (98.9 days), with no significant difference in CLABSI incidence between repair and replacement.

Conclusions:

• Central venous catheter (CVC) fracture is a common issue in pediatric patients with tunneled CVCs.
• CVC repair does not increase the incidence of CVC-associated bloodstream infections (CLABSI).
• CVC repair avoids the intraoperative and anesthetic risks associated with CVC replacement.