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Published on: December 23, 2014
Retained Central Venous Catheters in Pediatric Patients: Challenges, Mechanisms, and Surgical Strategies-A Narrative
Alice Gismondi1, Tommaso Domenico D'Angelo1, Chiara Grimaldi1
1Surgical Oncology Unit, Ospedale Pediatrico Bambino Gesù, IRCCS, Rome, Italy.
Background:
Long-term central venous catheters (CVCs) play a critical role in the management of pediatric patients with chronic illnesses, particularly in oncology. These devices provide reliable vascular access for the administration of chemotherapy, total parenteral nutrition, antibiotics, blood products, and frequent blood sampling.
Objective:
Review the etiology, complications, and management of retained long-term central venous catheters in children.
Methods:
This review analyzes existing literature and clinical experience to highlight mechanisms of catheter adherence and embolization, with a focus on pediatric-specific challenges.
Results:
Prolonged catheterization may lead to endothelial injury and fibrotic adherence of the catheter to the vessel wall. Catheter fracture with embolization is a rare but serious complication. Management includes surgical, endovascular, and conservative approaches. Pediatric-specific ethical considerations are vital when fragments are left in situ.
Conclusion:
Awareness of risk factors and timely intervention strategies can mitigate complications from retained CVCs. Further research is needed to understand the long-term effects and improve clinical guidelines.
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