title: Analysis of risk factors for central venous catheter-related complications: a prospective observational study in pediatric patients with bone sarcomas.
abstract: BACKGROUND
  The incidence of central venous catheter (CVC)-related complications reported in pediatric sarcoma patients is not established as reports in available literature are limited. The analysis of risk factors is part of the strategy to reduce the incidence of CVC complications.
  
  
  OBJECTIVE
  The objective of this study was to determine the incidence of CVC complications in children with bone sarcomas and if defined clinical variables represent a risk factor.
  
  
  METHODS
  During an 8-year period, 155 pediatric patients with bone sarcomas were prospectively followed up for CVC complications. Incidence and correlation with clinical features including gender, age, body mass index, histology, disease stage, and use of thromboprophylaxis with low-molecular-weight heparin were analyzed.
  
  
  RESULTS
  Thirty-three CVC complications were recorded among 42 687 CVC-days (0.77 per 1000 CVC-days). No correlation between the specific clinical variables and the CVC complications was found. A high incidence of CVC-related sepsis secondary to gram-negative bacteria was observed.
  
  
  CONCLUSIONS
  The analysis of CVC complications and their potential risk factors in this sizable and relatively homogeneous pediatric population with bone sarcomas has led to the implementation of a multimodal approach by doctors and nurses to reduce the incidence and morbidity of the CVC-related infections, particularly those related to gram-negative bacteria.
  
  
  CONCLUSIONS
  As a result of this joint medical and nursing study, a multimodal approach that included equipping faucets with water filters, the reeducation of doctors and nurses, and the systematic review of CVC protocol was implemented.
authors.affiliation: Author Affiliations: Department of Chemotherapy (Dr Abate, Ms Boschi, Ms Raspanti, Dr Cesari, Dr Paioli, Dr Palmerini, Dr Ferrari), Radiology Section (Ms Loro), and Ultrasound Section (Dr Affinito), Istituto Ortopedico Rizzoli, Bologna, Italy; and Pediatric Oncology Unit (Dr Escobosa Sánchez), Carlos Haya Hospital, Málaga, Spain.
authors.forename: Massimo Eraldo
authors.initials: ME
authors.lastname: Abate
authors.forename: Olga Escobosa
authors.initials: OE
authors.lastname: Sánchez
authors.forename: Rita
authors.initials: R
authors.lastname: Boschi
authors.forename: Cinzia
authors.initials: C
authors.lastname: Raspanti
authors.forename: Loretta
authors.initials: L
authors.lastname: Loro
authors.forename: Domenico
authors.initials: D
authors.lastname: Affinito
authors.forename: Marilena
authors.initials: M
authors.lastname: Cesari
authors.forename: Anna
authors.initials: A
authors.lastname: Paioli
authors.forename: Emanuela
authors.initials: E
authors.lastname: Palmerini
authors.forename: Stefano
authors.initials: S
authors.lastname: Ferrari
mesh_terms: D000293:Adolescent; D000970:Antineoplastic Agents / Q000008:administration & dosage; D001859:Bone Neoplasms / Q000188:drug therapy / Q000453:epidemiology / Q000451:nursing*; D055499:Catheter-Related Infections / Q000453:epidemiology / Q000451:nursing*; D002405:Catheterization, Central Venous / Q000451:nursing*; D062905:Central Venous Catheters / Q000009:adverse effects; D017024:Chemotherapy, Adjuvant / Q000451:nursing*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D016905:Gram-Negative Bacterial Infections / Q000453:epidemiology / Q000451:nursing*; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D007558:Italy / Q000453:epidemiology; D008297:Male; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012509:Sarcoma / Q000188:drug therapy / Q000453:epidemiology / Q000451:nursing*; D013030:Spain / Q000453:epidemiology
chemical_list: D000970:Antineoplastic Agents