Central venous catheters in older children

Area of Science:

• Pediatric Medicine
• Medical Devices
• Infectious Disease

Background:

• Cuffed Silastic catheters are used in children aged 1-18.
• This age group is considered high-risk for catheter-related complications.
• Existing data on pediatric catheter safety is limited compared to adults.

Purpose of the Study:

• To evaluate the safety and complication rates of cuffed Silastic catheters in pediatric patients.
• To compare complication rates in children with those reported in adult populations.
• To assess the impact of home use on catheter safety in pediatric patients.

Main Methods:

• Retrospective analysis of 89 cuffed Silastic catheters placed in children (1-18 years).
• Data collection on overall complication rates and sepsis rates.
• Comparison of complication rates between home-use and hospital-use, and with adult data.

Main Results:

• Overall complication rate: 1 per 288 days (higher than adults, lower than other pediatric series).
• Sepsis rate: 1 per 1236 days (nearly double the adult rate).
• Home use (35% of catheters) showed a lower overall complication rate (1 per 815 days) and similar sepsis rates to adults.

Conclusions:

• While overall complication rates are higher in children, home use of Silastic catheters is safer than anticipated.
• Pediatric patients, particularly outpatients, can safely use these catheters without fear of excessively high complication rates.
• Catheter acceptance by pediatric patients is good, supporting continued use, especially in outpatient settings.