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Tunneled, Noncuffed, Central Venous Catheters: High Success Rates When Used in Children Less Than 2 Years for
Siak Lee1,2, William Browne1, Alice Voskoboynik3
1Department of Anaesthesia and Pain Management, The Royal Children's Hospital, Melbourne, Victoria, Australia.
Aims:
Tunneled noncuffed central venous catheters (tncCVCs) have been used in pediatric populations for years. This study examines whether their use is efficacious and explores the reasons for complications and failure.
Methods:
This 6-year case series examines the success rate of tncCVCs inserted in patients less than 2 years old receiving intravenous antibiotics in a single institution and the reasons for device complications and failure.
Results:
Three hundred and thirty-one devices were inserted into 311 patients. Median patient age was 0.7 years (IQR 0.15-1.27) and median weight 7.8 kg (4.8-10.6). Median CVC dwell time was 13 (IQR 9.2-18.2) days. The success rate in completing prescribed treatment with the device was 94.9%, with 17 failures. Thirteen failures were due to accidental dislodgement (3.9% of all comers, 77% of failures). A large majority (79%) of patients received outpatient antibiotic therapy. Patients with any history of previous CVC insertion were more likely to have failed devices. All neonatal patient devices successfully completed treatment. A total of 55 different proceduralists inserted the devices.
Conclusions:
Success rates for tncCVCs when used in infants to complete a median of 13 days of antibiotic therapy on a single device appear acceptable.
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