Prospective study of indwelling central venous catheter-related complications in children with broviac or clampless valved catheters.
OBJECTIVE
To compare two types of central venous catheters (Broviac and valved clampless) for the incidence and severity of catheter-related complications in children.


METHODS
The authors report data on the mechanical and infectious complications collected in a prospective analysis of 92 catheters inserted in 82 children from January 2000 to March 2001.


RESULTS
Two different devices were inserted: 51 Broviac and 41 clampless valved catheters. During the follow-up of 17,803 catheter-days 52 complications were observed: 40 mechanical episodes and 12 infectious events. In the Broviac group the median follow-up was 179 days and the total number of catheter-days was 10,911. A total of 29 complications were observed, occurring in 22 catheters (43%), with an overall incidence of 0.27/100 catheter-days. In the clampless group the median follow-up was 134 days and the total number of catheter days was 6893. A total of 23 complications were observed, occurring in 19 devices (46%), with an incidence of 0.32/100 catheter days.


CONCLUSIONS
There were no major differences in the incidence of mechanical or infectious complications between the two devices. Malfunction was more frequent in Broviac catheters, whereas catheter displacement occurred more frequently in clampless valved catheters. These results show the importance of central venous catheter-related mechanical complications in the management of children with hematologic or oncologic malignancies.
Fratino
Giuseppe
G
Department of Pediatric Surgery, G. Gaslini Children's Institute, Largo G. Gaslini, 5-(I) 16147 Genoa, Italy. giuseppefratino@ospedale-gaslini.ge.it
Molinari
Angelo C
AC
Mazzola
Cinzia
C
Giacchino
Mareva
M
Saracco
Paola
P
Bertocchi
Evelina
E
Castagnola
Elio
E
D000925:Anticoagulants / Q000008:administration & dosage / Q000627:therapeutic use; D002405:Catheterization, Central Venous / Q000009:adverse effects*; D002408:Catheters, Indwelling / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D004867:Equipment Design; D004868:Equipment Failure; D005260:Female; D005343:Fibrinolytic Agents / Q000008:administration & dosage / Q000627:therapeutic use; D005500:Follow-Up Studies; D019337:Hematologic Neoplasms / Q000150:complications / Q000628:therapy; D006493:Heparin / Q000008:administration & dosage / Q000627:therapeutic use; D006801:Humans; D015994:Incidence; D007239:Infections / Q000453:epidemiology / Q000209:etiology*; D019934:International Normalized Ratio; D007558:Italy / Q000453:epidemiology; D008297:Male; D009369:Neoplasms / Q000150:complications / Q000628:therapy; D011446:Prospective Studies; D015912:Thrombolytic Therapy
D000925:Anticoagulants; D005343:Fibrinolytic Agents; D006493:Heparin