Mechanical and infective central venous catheter-related complications: a prospective non-randomized study using Hickman and Groshong catheters in children with hematological malignancies.
The aim of this study was to compare the Hickman and Groshong central venous catheters (CVCs) for incidence and severity of catheter-related complications in children. Seventy-three patients with hematological malignancies were observed, 42 with Groshong CVCs and 31 with Hickman CVCs. The number of infective episodes per 100 CVC-days was not significantly different (0.25 in the Hickman group versus 0.13 in the Groshong group; P = 0.24). The most frequent type of CVC-related infection in both groups was microbiologically documented sepsis; in most cases Gram-positive bacteria were isolated. Neutropenia (P < 0.001 for both CVCs) and hospital CVC management (P = 0.0047 for the Hickman group, P < 0.001 for the Groshong group) emerged as the major risk factors for the outbreak of infections. The rate of mechanical complication episodes per 100 CVC-days was similar in both groups (1.01 in the Hickman group versus 1.1 in the Groshong group: P = 0.58). Some complications (fissures, ruptures, total lumen obstruction by clots) occurred only in the Groshong group. Our study did not demonstrate any statistically significant difference in the incidence of mechanical and infective CVC-related complications between these two types of catheter.
Biagi
E
E
Clinica Pediatrica dell'Università di Milano, Ospedale San Gerardo, Monza, Italy.
Arrigo
C
C
Dell'Orto
M G
MG
Balduzzi
A
A
Pezzini
C
C
Rovelli
A
A
Masera
G
G
Silvestri
D
D
Uderzo
C
C
D001424:Bacterial Infections / Q000453:epidemiology* / Q000209:etiology; D002405:Catheterization, Central Venous / Q000009:adverse effects* / Q000295:instrumentation; D002648:Child; D002675:Child, Preschool; D004867:Equipment Design; D005260:Female; D019337:Hematologic Neoplasms / Q000628:therapy*; D006801:Humans; D015994:Incidence; D008297:Male; D011446:Prospective Studies; D012307:Risk Factors; D013927:Thrombosis / Q000453:epidemiology* / Q000209:etiology