[Clinical experience with totally implantable venous access systems in pediatric hematology and oncology].
Forty-three children with malignant diseases who received 48 totally implanted venous accesses (TIVA) were retrospectively analyzed. More than half the patients had acute leukemia. Mean age was 6 years 10 months. Mean duration of use of the TIVA was 473 +/- 50 days (range 28 to 1,285 da; median 424 days). Removal of the TIVA was required because of an adverse event in 33% of cases. Main reasons for removal included infection (22.9%), thrombosis (6.25%), and catheter dysfunction (4.16%). Catheter-related infections were most often due to staphylococci (90%), especially S. epidermidis (63%). Infection rate was 0.48 per 1,000 patient-days. Flushing with a vancomycin-heparin solution can be expected to decrease this rate. Selection of the implantation site is discussed. In children under 6 years of age, the cephalic vein and external jugular vein are often frail or absent and are therefore less appropriate than the internal jugular vein or subclavian vein.
Maloisel
F
F
Service d'Onco-Hématologie, CHU de Hautepierre, Strasbourg.
Geiss
S
S
Clavert
J M
JM
Amaral
D
D
Babin-Boilletot
A
A
D000293:Adolescent; D002408:Catheters, Indwelling / Q000009:adverse effects; D002648:Child; D002675:Child, Preschool; D004868:Equipment Failure / Q000706:statistics & numerical data; D006402:Hematologic Diseases / Q000188:drug therapy*; D006493:Heparin / Q000627:therapeutic use; D006801:Humans; D007223:Infant; D007239:Infections / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology / Q000382:microbiology; D009369:Neoplasms / Q000188:drug therapy*; D012189:Retrospective Studies; D013927:Thrombosis / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology; D014640:Vancomycin / Q000627:therapeutic use
D014640:Vancomycin; D006493:Heparin
Expérience clinique des systèmes veineux totalement implantables en hématologie et oncologie pédiatriques.