Top

Pediatric Surgery International

Published in:

01-07-2009 | Original Article

Incidence of indwelling central venous catheter-related complications using the Sri Paran technique for device fixation in children with cancer

Authors: G. Fratino, S. Avanzini, A. C. Molinari, P. Buffa, E. Castagnola, R. Haupt

Published in: Pediatric Surgery International | Issue 7/2009

Abstract

Purpose

Mechanical complications in tunneled indwelling central venous catheters (CVCs) often involve a risk of displacement. Fixation procedures are, therefore, of primary importance. We prospectively evaluated the incidence of CVC-related mechanical and infectious complications observed in devices fixated with the Sri Paran technique.

Methods

All CVCs inserted in children with cancer at our Institution from October 2005 to January 2007 were prospectively monitored for device-related mechanical and infectious complications. The Sri Paran fixation technique was used in all cases. The complication rate per 1,000 days was calculated as 1,000 times the number of complications divided by the total number of catheter days.

Results

Ninety-five CVCs were positioned in 84 children. The overall length of observation ranged between 41 and 482 days for a total of 18,618 catheter days. Mechanical complications occurred in 5% of the devices (specific rate 0.27); infections were observed in 6% of the devices (specific rate 0.32). No complications were observed during the first 30 days after CVC insertion.

Conclusions

The results, we obtained with the Sri Paran technique are extremely encouraging. Yet, randomized studies are required to prove these preliminary data.

Eastridge BJ, Lefor AT (1995) Complications of indwelling venous access devices in cancer patients. J Clin Oncol 13:233–238PubMed

Fratino G, Mazzola C, Buffa P et al (2001) Mechanical complications related to indwelling central venous catheter in pediatric haematology/oncology patients. Pediatr Hematol Oncol 18:317–324PubMedCrossRef

Journeycake JM, Buchanan GR (2003) Thrombotic complications of central venous catheters in children. Curr Opin Hematol 10(5):369–374PubMedCrossRef

Mermel LA, Farr BM, Sherertz RJ et al (2001) Infectious Diseases Society of America, American College of Critical Care Medicine, Society for Healthcare Epidemiology of America. Guidelines for the management of intravascular catheter-related infections. J Intraven Nurs 24(3):180–205PubMed

Cesaro S, Corrò R, Pelosin A et al (2004) A prospective survey on incidence and outcome of Broviac/Hickman catheter-related complications in pediatric patients affected by hematological and oncological diseases. Ann Hematol 83(3):183–188PubMedCrossRef

Fratino G, Castagnola E, Carlini C et al (2004) A single institution observational study of early mechanical complications in central venous catheters (valved and open-ended) in children with cancer. Pediatr Surg Int 20(9):704–707PubMedCrossRef

Sri Paran T, Corbally M, Fitzgerald RI (2003) New technique for fixation of Broviac catheters. J Pediatr Surg 38(1):51–52PubMedCrossRef

Fratino G, Molinari AC, Parodi S et al (2005) Central venous catheter-related complications in children with oncological/hematological diseases: an observational study of 418 devices. Ann Oncol 16(4):648–654PubMedCrossRef

Racadio JM, Doellman DA, Johnson ND et al (2000) Pediatric peripherally inserted central catheters: complication rates related to catheter tip location. Pediatrics 107(2):E28CrossRef

10.

Guth AA (2001) Routine chest X-rays after insertion of implantable long-term venous catheters: necessary or not? Am Surg 67(1):26–29PubMed

11.

Castagnola E, Molinari AC, Giacchino M et al (2007) Incidence of catheter-related infections within 30 days from insertion of Hickman–Broviac catheters. Pediatr Blood Cancer 48(1):35–38PubMedCrossRef

12.

Castagnola E, Molinari AC, Fratino G et al (2003) Conditions associated with infections of indwelling central venous catheters in cancer patients: a summary. Br J Haematol 121(2):233–239PubMedCrossRef

13.

Fratino G, Molinari AC, Mazzola C et al (2002) Prospective study of indwelling central venous catheter-related complications in children with Broviac or clampless valved catheters. J Pediatr Hematol Oncol 24(8):657–661PubMedCrossRef

14.

Shaul DB, Scheer B, Rokhsar S et al (1998) Risk factors for early infection of central venous catheters in pediatric patients. J Am Coll Surg 186(6):654–658PubMedCrossRef

15.

Boulay RM, Olt GJ, Podczaski ES (1998) Risk of venous access device wound complications in patients undergoing paclitaxel chemotherapy for gynecologic malignancies. Gynecol Oncol 70(2):259–262PubMedCrossRef

16.

Babu R, Spicer RD (2001) “Cuff-stitch” to prevent inadvertent dislodgement of central venous catheters. Pediatr Surg Int 17(2–3):245–246PubMedCrossRef

17.

Robinson JL, Tawfik G, Roth A (2005) Barriers to antibiotic lock therapy in children with intravascular catheter-related bloodstream infections. Pediatr Infect Dis J 24(10):944PubMedCrossRef

Title: Incidence of indwelling central venous catheter-related complications using the Sri Paran technique for device fixation in children with cancer
Authors: G. Fratino
S. Avanzini
A. C. Molinari
P. Buffa
E. Castagnola
R. Haupt
Publication date: 01-07-2009
Publisher: Springer-Verlag
Published in: Pediatric Surgery International / Issue 7/2009
Print ISSN: 0179-0358
Electronic ISSN: 1437-9813
DOI: https://doi.org/10.1007/s00383-009-2400-4

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Incidence of indwelling central venous catheter-related complications using the Sri Paran technique for device fixation in children with cancer

Abstract

Purpose

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 7/2009

Lawn mower-related projectile injury

Continuous lumbar/thoracic epidural analgesia in low-weight paediatric surgical patients: practical aspects and pitfalls

Management of colonic atresia with primary resection and anastomosis

Colonic transit studies: normal values for adults and children with comparison of radiological and scintigraphic methods

Usefulness of large pleural flap for the treatment of children with recurrent tracheoesophageal fistula

Jejunal Dieulafoy’s lesion: case report and literature review