title: Management of indwelling central venous catheters in pediatric cancer patients with fever and neutropenia.
abstract: This prospective study comprises 97 episodes of fever and neutropenia in children with cancer and central venous access. In 76% of episodes, patients had a Broviac-Hickman-like catheter, and in 24% a totally implanted venous access chamber system. The need for catheter removal during a febrile infection was 0.32/1000 catheter days, and the documented sepsis rate was 0.59/1000 catheter days. Our data indicate that 94% of episodes of fever and neutropenia in total, 78% of documented septicemias, and 97% of fevers of unknown origin were curable with broad-coverage antimicrobial therapy without removing the central venous line. Totally implanted chambers had a lower infection rate than catheters of Broviac-Hickman type.
authors.affiliation: Children's Hospital, University of Helsinki, Finland.
authors.forename: P
authors.initials: P
authors.lastname: Riikonen
authors.forename: U M
authors.initials: UM
authors.lastname: Saarinen
authors.forename: K M
authors.initials: KM
authors.lastname: Lähteenoja
authors.forename: H
authors.initials: H
authors.lastname: Jalanko
mesh_terms: D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D016470:Bacteremia / Q000188:drug therapy* / Q000209:etiology; D002405:Catheterization, Central Venous / Q000009:adverse effects* / Q000379:methods; D002408:Catheters, Indwelling; D002648:Child; D002675:Child, Preschool; D005260:Female; D005334:Fever / Q000209:etiology*; D006801:Humans; D007223:Infant; D008297:Male; D009369:Neoplasms / Q000150:complications* / Q000628:therapy; D009503:Neutropenia / Q000209:etiology*; D011446:Prospective Studies
chemical_list: D000900:Anti-Bacterial Agents