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

被引:35
作者
van den Bosch, Ceder H. [1 ]
van der Bruggen, J. Tjomme [2 ]
Frakking, Florine N. J. [2 ]
van Scheltinga, Cecilia E. J. Terwisscha [1 ]
van de Ven, Cornelis P. [1 ]
van Grotel, Martine [3 ]
Wellens, Lianne M. [1 ]
Loeffen, Yvette G. T. [4 ]
Fiocco, Marta [5 ,6 ,7 ,8 ]
Wijnen, Marc H. W. A. [1 ]
机构
[1] Princess Maxima Ctr Pediat Oncol, Dept Pediat Surg Oncol, Heidelberglaan 25, NL-3584 CS Utrecht, Netherlands
[2] Univ Med Ctr Utrecht, Dept Med Microbiol, Heidelberglaan 100, NL-3584 CX Utrecht, Netherlands
[3] Princess Maxima Ctr Pediat Oncol, Dept Pediat Oncol, Heidelberglaan 25, NL-3584 CX Utrecht, Netherlands
[4] Wilhelmina Childrens Hosp, Dept Pediat Infect Dis & Immunol, Tundlaan 6, NL-3584 EA Utrecht, Netherlands
[5] Princess Maxima Ctr Pediat Oncol, Med Stat, Heidelberglaan 25, NL-3584 CS Utrecht, Netherlands
[6] Math Inst, Niels Bohrweg 1, NL-2333 CA Leiden, Netherlands
[7] Leiden Univ, Rapenburg 70, NL-2311 EZ Leiden, Netherlands
[8] Leiden Univ, Med Ctr, Dept Biomed Data Sci, Einthovenweg 20, NL-2333 ZC Leiden, Netherlands
关键词
Pediatric oncology; Central line complications; CLABSI; CENTRAL VENOUS CATHETER; BLOOD-STREAM INFECTIONS; PORT-A-CATH; ITALIAN ASSOCIATION; ACCESS DEVICES; CHILDREN; HEMATOLOGY; CANCER; SURVEILLANCE; CHEMOTHERAPY;
D O I
10.1016/j.jpedsurg.2018.10.054
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
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: 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 (T1VAPs), Hickman-Broviac (R) (FIB), nontunneled, and peripherally inserted CVADs. 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: 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: Prognosis study (retrospective). (C) 2018 The Author(s). Published by Elsevier Inc.
引用
收藏
页码:1894 / 1900
页数:7
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