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Simultaneous bilateral central catheters: a safe technique.

D Jakobowski, M Moon, A Arbeter

    JPEN. Journal of Parenteral and Enteral Nutrition
    |July 1, 1982
    PubMed
    Summary
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    Using bilateral central catheters for nutrition and sampling in pediatric bone marrow transplant patients is safe. This approach demonstrated a lower complication rate compared to unilateral catheter use in similar immunocompromised populations.

    Area of Science:

    • Pediatric Hematology
    • Oncology
    • Critical Care Medicine

    Background:

    • Optimal central catheter care typically restricts use for sampling and blood products to maintain sterility.
    • Bone marrow transplant patients often require extensive central catheter access for nutrition, medications, and sampling.

    Purpose of the Study:

    • To evaluate the safety and efficacy of utilizing bilateral central venous catheters in pediatric patients undergoing bone marrow transplantation.
    • To compare complication rates between bilateral and unilateral central catheter use in immunocompromised children.

    Main Methods:

    • Bilateral percutaneous subclavian silastic catheters were inserted in 25 pediatric bone marrow transplant patients.
    • One catheter provided nutritional support; the contralateral catheter was used for daily sampling and medication administration.

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  • Surveillance cultures were monitored bi-weekly in a protective environment.

    • Main Results:

    • Nutritional therapy was administered for 876 days via 53 catheters.
    • Only one patient (4%) developed culture-proven sepsis, originating from the skin.
    • The patient complication rate (4%) and per diem rate (0.11%) were favorable compared to previous unilateral catheter data (10.5% and 0.32%).

    Conclusions:

    • Bilateral central catheters can be safely used in pediatric bone marrow transplant patients.
    • This approach allows for simultaneous nutritional support and sampling without increasing infection risk.
    • The findings challenge traditional concepts of central catheter care in highly immunocompromised populations.