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Central venous catheters in older children
Insights
Silastic catheters in children show higher overall complication rates than adults, but home use is safer than expected. Pediatric catheter use, especially outpatient, is acceptable despite risks.
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.
Abstract:
This report discusses the safety of 89 cuffed, Silastic (Dow Corning, Midland, MI) catheters placed in children between the ages of 1 and 18, a group that may be considered high risk on the basis of age. The overall complication rate was once every 288 days, three times more often than in published results in adults, but less often than in other pediatric series. The sepsis rate of once each 1236 days was almost twice the adult rate. Thirty (35%) of the catheters were used at home, accounting for 85 per cent of the total catheter use. Among this group, the overall complication rate was only once every 815 days, three times less frequent than in comparable adult series. The complication rate due to sepsis was once each 2444 days, the same as noted in adults. Whereas these catheters may be more hazardous overall in this age group, home usage appears to be safer than expected. These catheters are well accepted by this age group and their use, particularly among outpatients, should not be restricted for fear of an unacceptably high complication rate.