Safety and effectiveness of subcutaneously anchored securement for tunneled central catheters in oncological pediatric patients: A retrospective study.


Journal

The journal of vascular access
ISSN: 1724-6032
Titre abrégé: J Vasc Access
Pays: United States
ID NLM: 100940729

Informations de publication

Date de publication:
Jan 2023
Historique:
pubmed: 6 6 2021
medline: 18 1 2023
entrez: 5 6 2021
Statut: ppublish

Résumé

Proper securement of central venous catheters plays an important role in onco-hematological pediatric patients. A new subcutaneously anchored securement device has been recently introduced in the clinical practice, and it has been extensively used in children. In our study, we have retrospectively investigated the safety and the effectiveness of such device, reviewing the experience of three Italian pediatric oncological units. We have considered only tunneled catheters (cuffed or non-cuffed) inserted in children with malignancy; all types of tunneled central catheters were included in the analysis (both centrally and peripherally inserted) as long as they were secured with a subcutaneously anchored device. We investigated the incidence of dislodgment and of other catheter-related complications, with special attention to local adverse effects potentially related to the securement device. We collected data from 311 tunneled catheters of different caliber: 80.4% were centrally inserted central catheters (CICC), 15.4% were peripherally inserted (PICC), and 4.2% were femorally inserted. Approximately half of the catheters (51%) were non-cuffed. Incidence of dislodgment was very low (2.6%) and the incidence of local pain or inflammation potentially related to the securement device was minimal (1.9%). Catheter related bacteremias were below 1 episode/1000 catheter days. No symptomatic catheter related thrombosis was reported. There was no significant difference in complications comparing cuffed versus non-cuffed catheters, or CICCs versus PICCs, or hematologic tumors versus solid tumors. In our retrospective analysis of a vast population of oncological pediatric patients with tunneled central catheters, the subcutaneously anchored securement device was tolerated very well, and it was highly effective in preventing dislodgment, both in cuffed and non-cuffed catheters.

Sections du résumé

BACKGROUND UNASSIGNED
Proper securement of central venous catheters plays an important role in onco-hematological pediatric patients. A new subcutaneously anchored securement device has been recently introduced in the clinical practice, and it has been extensively used in children.
METHOD UNASSIGNED
In our study, we have retrospectively investigated the safety and the effectiveness of such device, reviewing the experience of three Italian pediatric oncological units. We have considered only tunneled catheters (cuffed or non-cuffed) inserted in children with malignancy; all types of tunneled central catheters were included in the analysis (both centrally and peripherally inserted) as long as they were secured with a subcutaneously anchored device. We investigated the incidence of dislodgment and of other catheter-related complications, with special attention to local adverse effects potentially related to the securement device.
RESULTS UNASSIGNED
We collected data from 311 tunneled catheters of different caliber: 80.4% were centrally inserted central catheters (CICC), 15.4% were peripherally inserted (PICC), and 4.2% were femorally inserted. Approximately half of the catheters (51%) were non-cuffed. Incidence of dislodgment was very low (2.6%) and the incidence of local pain or inflammation potentially related to the securement device was minimal (1.9%). Catheter related bacteremias were below 1 episode/1000 catheter days. No symptomatic catheter related thrombosis was reported. There was no significant difference in complications comparing cuffed versus non-cuffed catheters, or CICCs versus PICCs, or hematologic tumors versus solid tumors.
CONCLUSION UNASSIGNED
In our retrospective analysis of a vast population of oncological pediatric patients with tunneled central catheters, the subcutaneously anchored securement device was tolerated very well, and it was highly effective in preventing dislodgment, both in cuffed and non-cuffed catheters.

Identifiants

pubmed: 34088245
doi: 10.1177/11297298211009364
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

35-40

Auteurs

Alessandro Crocoli (A)

Surgical Oncology Unit, Bambino Gesù Children Hospital IRCCS, Rome, Italy.

Cristina Martucci (C)

Surgical Oncology Unit, Bambino Gesù Children Hospital IRCCS, Rome, Italy.

Luca Sidro (L)

Department of Anesthesiology and Intensive Care, Santobono-Pausilipon Children Hospital, Naples, Italy.

Daniela Delle Donne (D)

Department of Anesthesiology and Intensive Care, Santobono-Pausilipon Children Hospital, Naples, Italy.

Giuseppe Menna (G)

Department of Pediatric Hemato-Oncology, Santobono-Pausilipon Children Hospital, Naples, Italy.

Mauro Pittiruti (M)

Fondazione Policlinico Universitario A. Gemelli, Rome, Italy.

Maria Debora De Pasquale (MD)

Department of Oncohematology, Bambino Gesù Children Hospital IRCCS, Rome, Italy.

Luisa Strocchio (L)

Department of Oncohematology, Bambino Gesù Children Hospital IRCCS, Rome, Italy.

Gian Luigi Natali (GL)

Oncohematologic Interventional Radiology Unit, Imaging Department, Bambino Gesù Children Hospital IRCCS, Rome, Italy.

Alessandro Inserra (A)

Surgical Oncology Unit, Bambino Gesù Children Hospital IRCCS, Rome, Italy.

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Classifications MeSH