Incidence, severity and outcome of central line related complications in pediatric oncology patients; A single center study.

Catheter-Related Infections / epidemiology Catheterization, Central Venous / adverse effects Central Venous Catheters / adverse effects Child Humans Incidence Neoplasms / epidemiology Retrospective Studies
CLABSI Central line complications Pediatric oncology

Journal

Journal of pediatric surgery
ISSN: 1531-5037
Titre abrégé: J Pediatr Surg
Pays: United States
ID NLM: 0052631

Informations de publication

Date de publication:
Sep 2019
Historique:
received: 22 06 2018
revised: 02 10 2018
accepted: 05 10 2018
pubmed: 13 11 2018
medline: 21 12 2019
entrez: 13 11 2018
Statut: ppublish

Résumé

Central venous access device (CVAD)-related complications are associated with high morbidity rates. This study was performed to underline the importance of CVAD-complication prevention and treatment. An audit of practice of CVAD-related complications in pediatric oncology patients receiving a CVAD between January 2015 and June 2017 was performed. CVADs included were totally implantable venous access ports (TIVAPs), Hickman-Broviac® (HB), nontunneled, and peripherally inserted CVADs. A total of 201 children, with 307 CVADs, were analyzed. The incidence rates per 1000 CVAD-days for the most common complications were 1.66 for malfunctions, and 1.51 for central line-associated bloodstream infections (CLABSIs). Of all CVADs inserted, 37.1% were removed owing to complications, of which 45.6% were owing to CLABSIs. In 42% of the CLABSIs, the CLABSI could be successfully cured with systemic antibiotic treatment only. Of all included patients, 5.0% were admitted to the intensive care unit owing to CLABSI. The HB-CVAD compared to the TIVAP was a risk factor for CVAD-related complications, CLABSIs and dislocations in particular. The incidence of CVAD-related complications is high. Research on the prevention and treatment of CVAD-related complications in pediatric oncology patients should be a high priority for all health care professionals. Prognosis study (retrospective). Level II.

Sections du résumé

BACKGROUND BACKGROUND
Central venous access device (CVAD)-related complications are associated with high morbidity rates. This study was performed to underline the importance of CVAD-complication prevention and treatment.
METHODS METHODS
An audit of practice of CVAD-related complications in pediatric oncology patients receiving a CVAD between January 2015 and June 2017 was performed. CVADs included were totally implantable venous access ports (TIVAPs), Hickman-Broviac® (HB), nontunneled, and peripherally inserted CVADs.
RESULTS RESULTS
A total of 201 children, with 307 CVADs, were analyzed. The incidence rates per 1000 CVAD-days for the most common complications were 1.66 for malfunctions, and 1.51 for central line-associated bloodstream infections (CLABSIs). Of all CVADs inserted, 37.1% were removed owing to complications, of which 45.6% were owing to CLABSIs. In 42% of the CLABSIs, the CLABSI could be successfully cured with systemic antibiotic treatment only. Of all included patients, 5.0% were admitted to the intensive care unit owing to CLABSI. The HB-CVAD compared to the TIVAP was a risk factor for CVAD-related complications, CLABSIs and dislocations in particular.
CONCLUSIONS CONCLUSIONS
The incidence of CVAD-related complications is high. Research on the prevention and treatment of CVAD-related complications in pediatric oncology patients should be a high priority for all health care professionals.
TYPE OF STUDY METHODS
Prognosis study (retrospective).
LEVEL OF EVIDENCE METHODS
Level II.

Identifiants

DOI: 10.1016/j.jpedsurg.2018.10.054 PMID: 30415957
pubmed: 30415957
pii: S0022-3468(18)30687-0
doi: 10.1016/j.jpedsurg.2018.10.054
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

1894-1900

Informations de copyright

Copyright © 2018 The Author(s). Published by Elsevier Inc. All rights reserved.

Auteurs

Ceder H van den Bosch (CH)

Department of Pediatric Surgical Oncology, Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584, CS, Utrecht, The Netherlands. Electronic address: cedervandenbosch@gmail.com.

J Tjomme van der Bruggen (JT)

Department of Medical Microbiology, University Medical Center Utrecht, Heidelberglaan 100, 3584, CX, Utrecht, The Netherlands. Electronic address: j.t.vanderbruggen@umcutrecht.nl.

Florine N J Frakking (FNJ)

Department of Medical Microbiology, University Medical Center Utrecht, Heidelberglaan 100, 3584, CX, Utrecht, The Netherlands. Electronic address: f.n.j.frakking@umcutrecht.nl.

Cecilia E J Terwisscha van Scheltinga (CEJ)

Department of Pediatric Surgical Oncology, Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584, CS, Utrecht, The Netherlands. Electronic address: C.E.J.TerwisschavanScheltinga@prinsesmaximacentrum.nl.

Cornelis P van de Ven (CP)

Department of Pediatric Surgical Oncology, Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584, CS, Utrecht, The Netherlands. Electronic address: c.p.vandeven-4@umcutrecht.nl.

Martine van Grotel (M)

Department of Pediatric Oncology, Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584, CS, Utrecht, The Netherlands. Electronic address: M.vanGrotel@prinsesmaximacentrum.nl.

Lianne M Wellens (LM)

Department of Pediatric Surgical Oncology, Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584, CS, Utrecht, The Netherlands. Electronic address: l.m.wellens@prinsesmaximacentrum.nl.

Yvette G T Loeffen (YGT)

Department of Pediatric Infectious diseases and Immunology, Wilhelmina Children's Hospital, Lundlaan 6, 3584, EA, Utrecht, The Netherlands. Electronic address: Y.G.T.Loeffen-2@umcutrecht.nl.

Marta Fiocco (M)

Medical Statistics, Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584, CS, Utrecht, The Netherlands; Mathematical Institute, Niels Bohrweg 1, 2333, CA, Leiden, the Netherlands; Leiden University, Rapenburg 70, 2311, EZ, Leiden, the Netherlands; Department of Biomedical Data Sciences, Leiden University Medical Center, Einthovenweg 20, 2333, ZC, Leiden, The Netherlands. Electronic address: m.fiocco@lumc.nl.

Marc H W A Wijnen (MHWA)

Department of Pediatric Surgical Oncology, Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584, CS, Utrecht, The Netherlands. Electronic address: M.H.W.Wijnen-5@prinsesmaximacentrum.nl.

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Classifications MeSH

questionsmedicales.fr › Infection › Infections sur cathéters › Incidence, severity and outcome of central...
questionsmedicales.fr › Techniques d'investigation › Cathétérisme › Cathétérisme veineux central › Incidence, severity and outcome of central...
questionsmedicales.fr › Équipement et fournitures › Cathéters › Dispositifs d'accès vasculaires › Voies veineuses centrales › Incidence, severity and outcome of central...
questionsmedicales.fr › Personnes › Tranches d'âge › Enfant › Incidence, severity and outcome of central...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Incidence, severity and outcome of central...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Collecte de données › Registre civil › Morbidité › Incidence › Incidence, severity and outcome of central...
questionsmedicales.fr › Tumeurs › Incidence, severity and outcome of central...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Caractéristiques des études épidémiologiques › Études épidémiologiques › Études de cohortes › Études rétrospectives › Incidence, severity and outcome of central...