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Non-tunneled catheters in children undergoing bone marrow transplantation

L Madero1, D Ruano, M Villa

  • 1Department of Pediatric Hematology and Oncology, Autonomous University of Madrid, Spain.

Bone Marrow Transplantation
|January 1, 1996
PubMed

Insights

Non-tunneled central venous catheters (CVCs) are effective for pediatric bone marrow transplant patients, despite potential complications like infections and pneumothorax. Their use is recommended during critical transplant phases.

Area of Science:

  • Pediatric critical care medicine
  • Hematology and oncology
  • Vascular access devices

Background:

  • Central venous catheters (CVCs) are essential for administering therapies in pediatric patients undergoing bone marrow transplantation (BMT).
  • Non-tunneled polyurethane double lumen CVCs are frequently utilized for short-term access.
  • Assessing the safety and efficacy of these devices in this vulnerable population is crucial.

Purpose of the Study:

  • To evaluate the outcomes and complications associated with the use of non-tunneled CVCs in children undergoing bone marrow transplantation.
  • To determine the incidence of infectious and non-infectious complications.
  • To assess the appropriateness of non-tunneled CVCs during specific phases of BMT.

Main Methods:

  • Retrospective analysis of 62 pediatric patients who received non-tunneled (polyurethane double lumen) CVCs.
  • Catheter insertion performed in the Critical Care Unit without surgery or general anesthesia.
  • Documentation of all insertion-related complications, infections, and reasons for catheter removal.

Main Results:

  • Complications included pneumothorax/hemopneumothorax (6.06%), entry site infection (9.6%), catheter-related infection (12.9%), and catheter-related sepsis (14.5%).
  • Catheters were removed upon therapy completion (74.1%), due to death (11.3%), or infection (14.5%).
  • Despite noted complications, the overall utility was deemed significant.

Conclusions:

  • Non-tunneled CVCs are a viable option for pediatric BMT patients during conditioning, transplantation, and immediate post-transplantation periods.
  • Careful monitoring and management are necessary to mitigate associated risks.
  • The benefits of immediate access outweigh the risks in this critical patient group.

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