Results of a long-term, prospective study on complications of central venous catheter in pediatric patients with hematologic-oncologic diseases

被引：1

作者：

Garonzi, Chiara ^{[1
]}

Zeni, Francesca ^{[2
]}

Tridello, Gloria ^{[2
]}

Giacomazzi, Alice ^{[2
]}

Castagna, Alberto ^{[2
]}

Esposto, Maria Pia ^{[2
]}

Caddeo, Giulia ^{[2
]}

Pezzella, Vincenza ^{[2
]}

Zaccaron, Ada ^{[2
]}

Bonetti, Elisa ^{[2
]}

Vitale, Virginia ^{[2
]}

Chinello, Matteo ^{[2
]}

Balter, Rita ^{[2
]}

Guardini, Beatrice ^{[3
]}

Pedrazzoli, Eleonora ^{[3
]}

Cesaro, Simone ^{[2
]}

机构：

[1] Univ Verona, Dept Surg Sci Dent Pediat & Gynecol, Piazzale A Stefani 1, I-37126 Verona, Italy

[2] Azienda Osped Univ Integrata Verona, Pediat Hematol Oncol, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy

[3] Azienda Osped Univ Integrata Verona, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy

来源：

PEDIATRIC BLOOD & CANCER | 2024年 / 71卷 / 07期

关键词：

central venous catheter; chemotherapy; complications; pediatric malignancy; stem cell transplantation; BLOOD-STREAM INFECTIONS; CHILDREN;

D O I：

10.1002/pbc.30990

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

BackgroundCentral venous catheter (CVC)-related complications remain a significant cause of morbidity in pediatric hematology-oncology. We prospectively surveyed the incidence of CVC-related complications in children with hematologic-oncologic diseases. ProcedureFive-hundred-eighty-one CVCs were inserted in 421 patients from January 2010 to June 2022 (153,731 CVC days observation; follow-up data up to December 31, 2022). ResultsOverall, 671 complications were recorded (4.365/1000 CVC days): 49.7% malfunctions (1.88/1000 CVC days, 4.8% of CVC early removals), 23.9% bacteremia (0.90/1000, 15.1%), 19.6% mechanical complications (0.74/1000, 70.2%), 20.1% localized infections (0.76/1000, 17.1%), 0.5% thrombosis (0.02/1000, 33.3%). At multivariate analysis, risk factors for malfunction were Broviac-Hickman type of CVC (hazard ratio [HR] 2.5) or Port-a-cath (HR 3.4) or Proline (HR 4.3), p < .0001; for bacteremia double-lumen CVC (HR 3.2, p < .0001); for mechanical complications age at CVC insertion under median (HR 4.5, p < .0001) and Broviac-Hickman (HR 1.6) or Proline (HR 2.7), p = .01; finally for localized infections Broviac-Hickman (HR 2.9) or Proline (HR 4.4), p = .0001. The 2-year cumulative incidence of premature removal was 23.5%, and risk factors were age at CVC insertion under median (HR 2.4, p < .0001), Broviac-Hickman (HR 2.3) or Proline (HR 4.2), p < .0001. ConclusionsPremature removal occurs in approximately 20%-25% of long-term CVCs. A surveillance program has a fundamental role in identifying the risk factors for CVC complications and the areas of intervention to improve CVC management.

引用

页数：7