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[Medium- and long-term use of central venous catheters in pediatrics. Personal experience]
1Istituto di Anestesiologia e Rianimazione, Università degli Studi di Roma, La Sapienza.
Insights
Central venous catheters (CVCs) are well-tolerated in pediatric patients for various therapies. This study evaluated CVC use and complications in 62 pediatric patients, finding them safe for long-term use.
Area of Science:
- Pediatric Surgery
- Vascular Access
- Medical Devices
Background:
- Central venous catheters (CVCs) are essential for long-term therapies in pediatric patients.
- Appropriate selection of CVC type and insertion site is crucial for patient outcomes.
- Understanding complication rates is vital for optimizing CVC use in pediatric surgery.
Purpose of the Study:
- To evaluate the safety and efficacy of different types of central venous catheters (CVCs) in pediatric patients.
- To analyze the factors influencing the choice of CVC and insertion site.
- To report early and long-term complications associated with CVC use in pediatric patients.
Main Methods:
- Retrospective analysis of 74 CVC insertions in 62 pediatric patients over a 3-year period.
- Categorization of CVCs into totally implanted devices and percutaneous catheters.
- Documentation of insertion sites (subclavian and internal jugular veins) based on patient weight.
Main Results:
- A variety of CVCs were used, including Groshong, Broviac, Hickman, Port, and Arrow devices.
- Device selection was based on treatment duration, disease, and patient characteristics.
- Early complications included pneumothorax, hematomas, and arterial access; long-term complications involved infections, dislodgement, and occlusion.
Conclusions:
- Central venous catheters are well-tolerated and accepted in pediatric patients for antineoplastic, nutritional, and infusion therapies.
- The choice of CVC and insertion site can be tailored to individual patient needs and treatment duration.
- Monitoring for both early and late complications is essential for safe CVC management in pediatric populations.
Abstract:
From January 1992 to October 1994, 74 central venous catheters were inserted, in the University Hospital of Rome: Polyclinic Umberto I - "La Sapienza", in 62 paediatric patients (15.17 +/- 1.64 years old), admitted to the paediatric surgery division. The authors used a large amount of CVC: totally implanted devices (34 Groshong, 7 Broviac, 2 Hickman, 3 Port) and percutaneous catheters (28 Arrow). The choice of the infusional devices has been influenced by the length of the treatment, the primitive disease, the age and the size of the patient. The authors used totally implanted devices in paediatric patients undergoing chemotherapeutic and nutritional therapies. External central venous access devices were used in patients undergoing central catheterization lasting less than two months. The subclavian vein has been used as venous access in patients weighing > 5 kg, the internal jugular vein in < 5, kg patients. This work reports the early (PNX, hematomas, arterial access) and the long term complications (infections, accidental unthreading, occlusions and dislocations). We can say that the medium and long last term CVC is well tolerated and accepted in paediatric patients too, for antineoplastic, nutritional and infusion therapies.