Epidemiological features and complications of central venous catheters in pediatric oncology: prospective study about 125 cases

Objective. - To report the indications and early and late catheter-related complications in a Tunisian unit of paediatric oncology. Patients and methods. - This prospective study has been performed in a paediatric oncology unit of the Salah Azaiz Institute between 1989 and 2005. It concerns 58 girls and 57 boys with a median age of 7.9 years(4 months to 18 years) treated for cancer disease predominantly lymphoma (22%), sarcoma (23.2%) or leukaemia (8.5%) proposed for insertion of a central venous catheter (CVC). Results. - Excluding 2 insertion failures (1.6%), we placed 123 CVC (double for 10 patients), 43 (35%) exteriorised (EC) and 80 (65%) connected to an implantable site (IS). Catheters were placed in the subclavian vein in 59.2% of cases vs 32% for internal jugular vein and 8.8% for femoral vein. Early complications included 15 cases of multiple punctures (12%), 4 cases of pneumothorax (3.2%) and 6 of arterial punctures (4.8%) originating a cervical subcutaneous haematoma in 1 patient (0.8%). Late complications were represented by infection in 7 cases (5.7%). We observed 2 cases of intracardiac catheter migration due to catheter disconnection from the IS (1.6%) and 2 cases of thrombosis (1.8%). The mean life of CVC was longer for IS (305.2 days) than for EC (64.4 days). Conclusion. - Implantable sites are effective progress for venous access in children with cancer. They improved the quality of care in pediatric oncology. (c) 2006 Elsevier SAS. Tous droits reserves.