title: Complications of central venous access devices in children with and without cancer.
abstract: OBJECTIVE
  Complications of indwelling central venous access devices (CVAD) were assessed in 63 children with cancer and 35 without cancer.
  
  
  METHODS
  Central venous access devices placed surgically in 1991 were reviewed for complications.
  
  
  RESULTS
  In cancer patients, the median CVAD duration was 211 days (range 9-924), compared to 37 days (range 3-339) in the non-cancer patients. Although significantly more CVAD, 41 of 72 (57%), were infected in the cancer patients compared to 14 of 40 (35%) CVAD in the non-cancer patients (OR = 2.46, 95% CI 1.03-5.93), the rate of line infection in cancer patients was lower: 2.8 per 1000 catheter days compared with 7.6 per 1000 in non-cancer patients (P = 0.0014). Infection was significantly more common in intensive chemotherapy cancer patients (P = 0.0002).
  
  
  CONCLUSIONS
  Treating infected CVAD with antibiotics or hydrochloric acid (HCl), clearing occluded lines with streptokinase/HCl and repairing fractured lines, when successful, resulted in a considerable gain in the number of days of use for the CVAD.
authors.affiliation: Department of Immunology and Infectious Diseases, Royal Alexandra Hospital for Children, Westmead, New South Wales, Australia.
authors.forename: R
authors.initials: R
authors.lastname: Tobiansky
authors.forename: K
authors.initials: K
authors.lastname: Lui
authors.forename: D M
authors.initials: DM
authors.lastname: Dalton
authors.forename: P
authors.initials: P
authors.lastname: Shaw
authors.forename: H
authors.initials: H
authors.lastname: Martin
authors.forename: D
authors.initials: D
authors.lastname: Isaacs
mesh_terms: D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002405:Catheterization, Central Venous / Q000009:adverse effects* / Q000295:instrumentation; D002408:Catheters, Indwelling / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease / Q000628:therapy; D004868:Equipment Failure; D006801:Humans; D006851:Hydrochloric Acid; D007223:Infant; D007231:Infant, Newborn; D007239:Infections / Q000188:drug therapy / Q000209:etiology / Q000382:microbiology; D009369:Neoplasms / Q000150:complications / Q000628:therapy; D011446:Prospective Studies; D018805:Sepsis / Q000188:drug therapy / Q000209:etiology; D013242:Sterilization; D013300:Streptokinase
chemical_list: D000900:Anti-Bacterial Agents; D013300:Streptokinase; D006851:Hydrochloric Acid