Central venous catheter-related complications after bone marrow transplantation in children with hematological malignancies.
We studied infectious and mechanical complications occurring with 55 central venous catheters (CVCs) managed in hospital and at home, in 53 children with hematological malignancies who underwent bone marrow transplantation (BMT). The total catheter life span was 6906 days (median 111), 2359 days (median 40) in hospital and 4547 days (median 78.5) at home. Duration of neutropenia was 1241 days (median 20), mostly in hospital. We observed 21 CVC-related infections from 17/55 CVCs (31%): 0.30 episodes/100 days of CVC use with 0.55/100 days in hospital vs 0.17/100 days at home. Antibiotic treatment resolved 72% of infections without CVC removal, which was required in six instances. There were 14 mechanical complications (0.20 episodes/100 days of CVC use) in 6/55 CVCs (11%), with three removals. Interventions to resolve mechanical problems included catheter declotting by urokinase, repair and replacement. We conclude that CVC is an essential component of care of children with cancer undergoing BMT and that it has a relatively low complication rate. Most complications can be resolved by an appropriate CVC handling and by a multidisciplinary intervention in the critical post-BMT phase.
Uderzo
C
C
Pediatric Hematology Department, University of Milan, Italy.
D'Angelo
P
P
Rizzari
C
C
Viganò
E F
EF
Rovelli
A
A
Gornati
G
G
Codecasa
G
G
Locasciulli
A
A
Masera
G
G
D000293:Adolescent; D000754:Anemia, Refractory, with Excess of Blasts / Q000628:therapy*; D016026:Bone Marrow Transplantation; D002405:Catheterization, Central Venous / Q000009:adverse effects* / Q000295:instrumentation; D002648:Child; D002675:Child, Preschool; D004866:Equipment Contamination / Q000706:statistics & numerical data; D004868:Equipment Failure / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007239:Infections / Q000453:epidemiology / Q000209:etiology*; D007938:Leukemia / Q000628:therapy*; D008228:Lymphoma, Non-Hodgkin / Q000628:therapy*; D008297:Male; D011446:Prospective Studies; D018805:Sepsis / Q000453:epidemiology / Q000209:etiology