The use of central venous catheters in children receiving intensive oncotherapy in a developing country.
Fifty-three central venous access catheters were placed in 45 consecutive cancer patients younger than 13 years of age. Ten of the 16 children from a very poor socio-economic background were discharged and received their catheter care as outpatients. Catheters were left in situ for a mean period of 134 days and 159 days in the better and poor socio-economic groups respectively. In 19 cases catheters were removed before completion of chemotherapy. Reasons for early removal of catheters were technical factors in 9 patients, removal by the patient in 4 cases, blocked catheters or skin erosion at the exit site in 4 cases, and catheter sepsis in 2 patients. One febrile episode was recorded per 107 catheter days. Blood culture-proven sepsis occurred at a rate of 1.7 episodes per 1000 catheter days. There was no difference in the incidence of febrile episodes without obvious cause in patients from a good socio-economic background (1/100 catheter days) and in those from a socio-economically disadvantaged background (1/123 catheter days). The morbidity in patients from poor socio-economic circumstances who went home with long-term central venous access catheters in situ was acceptable.
Wessels
G
G
Department of Paediatrics and Child Health, University of Stellenbosch, Tygerberg, W. Cape.
Hesseling
P B
PB
Moore
S W
SW
D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000627:therapeutic use; D002405:Catheterization, Central Venous / Q000009:adverse effects / Q000379:methods / Q000706:statistics & numerical data; D002648:Child; D002675:Child, Preschool; D003362:Cost-Benefit Analysis; D003906:Developing Countries; D006801:Humans; D009369:Neoplasms / Q000628:therapy*; D011446:Prospective Studies; D012307:Risk Factors; D012959:Socioeconomic Factors; D013997:Time Factors
D000970:Antineoplastic Agents