Multipurpose central venous access in the immunocompromised pediatric patient.
During a 21-month period, 50 consecutive pediatric oncology patients undergoing bone marrow transplantation and/or cytoreductive chemotherapy had 61 silastic central venous catheters placed to facilitate their therapy. All catheters were used for medications, routine blood sampling, and transfusions, with 45% also used for hyperalimentation and 57% used for bone marrow transplantation. Catheters were utilized during both inpatient and outpatient therapy periods. Total catheter days numbered 8455, an average of 139 days per catheter. Forty-seven catheters (77%) were removed electively or were in place at time of patient death. Seven were removed for mechanical complications (1/1409 catheter days). Four additional episodes of presumed catheter sepsis were managed with antibiotics and did not require catheter removal (40% of septic episodes). One catheter is still in place after 585 days. Complication rates were not influenced by this multiple use protocol. With standardized catheter care and surveillance, multipurpose, long-term central venous access can be safely utilized in the immunosuppressed pediatric patient.
D000293:Adolescent; D001800:Blood Specimen Collection / Q000379:methods; D016026:Bone Marrow Transplantation; D002404:Catheterization / Q000009:adverse effects / Q000379:methods*; D002408:Catheters, Indwelling; D002648:Child; D002675:Child, Preschool; D004358:Drug Therapy / Q000379:methods; D006801:Humans; D007165:Immunosuppression Therapy; D007223:Infant; D009369:Neoplasms / Q000628:therapy*; D010289:Parenteral Nutrition, Total / Q000379:methods; D012826:Silicone Elastomers; D013997:Time Factors
D012826:Silicone Elastomers