Durability of central venous catheters. A randomized trial in children with malignant diseases

In a prospective randomized study the durability of tunnelled and non-tunnelled central venous catheters was investigated in children with malignant diseases. Twenty children were included in the study but four (two in each group) had to be excluded; three because the entry criteria turned out not to be fulfilled and one because of lack of data. The median duration of the tunnelled catheters was 224 days with a range of 25-846 days which was significantly longer than that of conventional catheters (39.5 days, range 9-228 days). In addition six of eight conventional catheters were accidentally removed whereas all catheters in the tunnelled group had to be removed via a small incision. Three cases of catheter related sepsis, two in the tunnelled group and one in the conventional group, were registered. The corresponding number of infections per catheter days were 1 in 1189 days and 1 in 522 days, respectively. In conclusion cuffed, tunnelled central venous catheters are less prone to displacement than traditional percutaneous central venous catheters when used in children with malignant diseases.