Use of percutaneous radial artery catheter for peripheral blood progenitor cell collection in pediatric patients.
BACKGROUND
Leukapheresis procedures require adequate flow rates, which in children may frequently involve invasive vascular access placement.


METHODS
A minimally invasive peripheral radial artery catheter was used for drawing blood in 85 leukapheresis procedures performed in 33 pediatric patients. Blood return to the patients was provided by either a central Broviac-type catheter or a peripheral venous access. The patients' age range was 1 to 18 years (median, 9.5) and the weight range was 9 to 73 kg (median, 29 kg). Vasocan Braunüle Luer Lock IV cannulas (22 gauge in 78 and 20 gauge in 7) were placed percutaneously under local anesthesia, and in 8 patients, catheter placement was carried out during general anesthesia for other procedures. A continuous flow cell separator was used in all cases (Fresenius AS104 in 23 and AS204 in 62).


RESULTS
Flow rates ranged from 18 to 45 mL per minute, the mean number of total blood volumes processed was 2.07 (range, 0.51-2.51), and the mean duration of the procedures was 150 minutes (range, 90-260). The 22-gauge cannulas provided adequate flow rates independently of patient age and weight. No significant thrombotic, embolic, hemorrhagic, ischemic, or infectious complications were observed.


CONCLUSIONS
Peripheral radial artery catheters are safe, are minimally invasive, and provide steady, high-flow rates, and they should be considered for patients requiring leukapheresis and lacking a suitable vascular access for drawing blood.
Bambi
Franco
F
Blood Bank and Hematology-Oncology Service, Department of Pediatrics, University of Florence, Children's Hospital A. Meyer, Florence, Italy. f.bambi@meyer.it
Fontanazza
Silvia
S
Messeri
Andrea
A
Lippi
Alma
A
Tucci
Fabio
F
Tamburini
Angela
A
Tintori
Veronica
V
Casini
Tommaso
T
Lacitignola
Laura
L
Tondo
Annalisa
A
Veltroni
Marinella
M
Bernini
Gabriella
G
Faulkner
Lawrence B
LB
D000293:Adolescent; D001327:Autoimmune Diseases / Q000628:therapy; D002408:Catheters, Indwelling / Q000009:adverse effects / Q000592:standards*; D002648:Child; D002675:Child, Preschool; D005260:Female; D019650:Hematopoietic Stem Cell Mobilization; D006801:Humans; D007223:Infant; D007937:Leukapheresis / Q000295:instrumentation / Q000379:methods*; D008297:Male; D009369:Neoplasms / Q000628:therapy; D036102:Peripheral Blood Stem Cell Transplantation / Q000379:methods; D017534:Radial Artery; D014182:Transplantation, Autologous / Q000379:methods