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Mechanical complications of central venous catheters in children: A cohort study

Kieran J Moore1, David Greencorn1, Nadine Smith2

  • 1Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada.

Infection Control and Hospital Epidemiology
|December 21, 2021
PubMed

Insights

Mechanical complications are common in pediatric central venous catheters (CVCs). Routine surveillance for these CVC complications is recommended to improve patient safety outcomes.

Area of Science:

  • Pediatric critical care medicine
  • Vascular access devices
  • Patient safety outcomes

Background:

  • Central venous catheters (CVCs) offer significant benefits but are linked to various complications.
  • Mechanical complications of CVCs are not routinely monitored, obscuring their true incidence and impact.
  • Understanding these complications is crucial for improving pediatric patient care.

Purpose of the Study:

  • To determine the incidence and characteristics of mechanical complications associated with central venous catheters (CVCs) in pediatric patients.
  • To evaluate the impact of CVC type and tip location on mechanical complication rates.
  • To advocate for routine reporting of CVC-associated mechanical complications.

Main Methods:

  • A retrospective review of prospectively collected data from a centralized database.
  • Inclusion of all pediatric patients (<19 years) with CVCs from January 2001 to June 2016.
  • Analysis of patient demographics, CVC characteristics, and mechanical complication rates per 1,000 catheter days.

Main Results:

  • A total of 8,747 CVCs were placed in 5,743 patients, accounting for 780,448 catheter days.
  • The overall mechanical complication rate was 6.1 per 1,000 catheter days.
  • Nontunneled lines exhibited the highest complication rates, and approximately 6% of CVCs were removed due to mechanical issues.

Conclusions:

  • Mechanical complications are a frequent and significant concern in pediatric CVC use.
  • Catheter tip location in the superior vena cava or right atrium was associated with fewer complications.
  • Routine surveillance and reporting of CVC-associated mechanical complications are proposed to enhance patient safety.
Abstract

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