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Multipurpose central venous access in the immunocompromised pediatric patient
JPEN. Journal of Parenteral and Enteral Nutrition
|January 1, 1985
Summary
Central venous catheters provide safe, long-term access for pediatric oncology patients receiving chemotherapy or bone marrow transplants. Multipurpose use of these catheters minimizes complications, enhancing patient care.
Area of Science:
- Pediatric Oncology
- Vascular Access Devices
- Hematology/Oncology
Background:
- Pediatric oncology patients require reliable vascular access for intensive treatments.
- Central venous catheters (CVCs) are essential for administering chemotherapy, transfusions, and supportive care.
Purpose of the Study:
- To evaluate the safety and efficacy of multipurpose, long-term central venous catheter utilization in pediatric oncology patients.
- To assess complication rates associated with intensive use of CVCs in immunosuppressed children.
Main Methods:
- A retrospective review of 61 silastic central venous catheters placed in 50 pediatric oncology patients over 21 months.
- Data collected included catheter dwell time, indications for use (medications, blood sampling, transfusions, hyperalimentation, bone marrow transplantation), and complications.
Main Results:
- A total of 8455 catheter days were recorded, with an average dwell time of 139 days per catheter.
- Mechanical complications occurred at a rate of 1 per 1409 catheter days.
- Presumed catheter sepsis episodes were managed successfully with antibiotics in 40% of cases without requiring catheter removal.
- Complication rates were not significantly influenced by the multipurpose use protocol.
Conclusions:
- Standardized care and surveillance enable safe, multipurpose, long-term central venous access in immunosuppressed pediatric oncology patients.
- This approach can effectively support complex treatment regimens, including bone marrow transplantation and chemotherapy.