title: [Subcutaneously inserted central intravascular devices in the pediatric oncology patient: can we minimize their infection].
abstract: Long-term indwelling central venous access devices are frequently used in pediatric patients. Their main complication is infection, that can even mean their removal. We try to identify the risk factors really involved in this complication and in their removal. We have made a retrospective review of 120 oncologic pediatric patients who received a central venous device between 2003 and 2009. We searched for epidemiologic, clinic, microbiologic and surgical risk factors. We made a comparative data analysis among: GROUP A, children who suffered device infection, GROUP B the others. Group A was divided into early infection (first month after implantation)/late infection, removed/not removed. Data were analized with statistical program SPSS. 29 suffered from leukemia, 19 from lymphoma and the main part, 72, from solid tumour. 31% experienced infection (GROUP A), being early in the 36% of them. 16% had to be withdrawn. Data analysis revealed statistical association with the age (p=0.015) and with the reception of chemiotherapic treatment the week before the surgical insertion. The rest of the studied factors did not revealed a real association, but could be guess a relationship among infection and leukemia, subclavian catheters, those patients whose deviced was introduced using a guide over a previous catheter and also transplanted. Related to early infection the only associateon founded was with the subclavian access (p=0.018). In conclusion, in our serie long-term central venous access infection was more frequent in the younger patients and also in those who had received chemotherapy the week before the catheter implantation. The tendency towards infection in leukemia, transplanted and subclavian carriers has to be studied in a prospective way with a larger number of oncologic children.
authors.affiliation: Servicio de Cirugía Pediátrica, Hospital Gregorio Marañón, Madrid. artardaguila@gmail.com
authors.forename: A R
authors.initials: AR
authors.lastname: Tardáguila
authors.forename: A
authors.initials: A
authors.lastname: Del Cañizo
authors.forename: M M
authors.initials: MM
authors.lastname: Santos
authors.forename: M
authors.initials: M
authors.lastname: Fanjul
authors.forename: C
authors.initials: C
authors.lastname: Corona
authors.forename: M
authors.initials: M
authors.lastname: Zornoza
authors.forename: A
authors.initials: A
authors.lastname: Parente
authors.forename: N
authors.initials: N
authors.lastname: Carrera
authors.forename: C
authors.initials: C
authors.lastname: Beléndez
authors.forename: J
authors.initials: J
authors.lastname: Cerdá
authors.forename: J
authors.initials: J
authors.lastname: Saavedra
authors.forename: E
authors.initials: E
authors.lastname: Molina
authors.forename: M A
authors.initials: MA
authors.lastname: García-Casillas
authors.forename: D
authors.initials: D
authors.lastname: Peláez
mesh_terms: D055499:Catheter-Related Infections / Q000209:etiology* / Q000517:prevention & control*; D002408:Catheters, Indwelling / Q000009:adverse effects*; D062905:Central Venous Catheters / Q000009:adverse effects*; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D009369:Neoplasms / Q000188:drug therapy*; D012189:Retrospective Studies