title: Contemporary Insertion of Central Venous Access Catheters in Pediatric Patients: A Retrospective Record Review Study of 538 Catheters in a Single Center.
abstract: OBJECTIVE
  To analyze the rate of infections and complications after surgeon-performed, largely ultrasound-guided, central venous catheter (CVC) placement in a pediatric population and to identify patients at high risk of complications.
  
  
  METHODS
  All children aged between 4 months and 19 years with a percutaneous CVC inserted between January 1, 2000, and July 31, 2013, were included. Patient records were reviewed retrospectively for the occurrence of infection and other complications until CVC removal or the last outpatient clinic visit and compared between patient groups and with the recent literature.
  
  
  RESULTS
  A total of 538 CVCs were placed in 345 patients. Eight patients (1.5%) suffered complications during placement. There were 84 cases of a suspected CVC infection (15.6%). Catheter-related infections with a positive catheter tip culture occurred in 25 cases (4.6%). Older patients (odds ratio [OR] 0.88; 95% confidence interval [CI] 0.78-0.98) or patients with a double-lumen 7 French Bard-Hickman catheter (OR 0.32; 95% CI 0.11-1.00) had a significantly lower risk of infection. Older patients (OR 0.94; 95% CI 0.89-0.99) and patients with beta-thalassemia (OR 0.35; 95% CI 0.17-0.71) also had a significantly lower risk of suspected infection.
  
  
  CONCLUSIONS
  In general, infection rates in our series were similar to those in the recent literature. Younger patients seem to be at higher risk for CVC removal because of infection prior to the end of treatment. Patients with beta-thalassemia or receiving a double-lumen 7F Bard-Hickman catheter had a lower risk of infection.
authors.affiliation: 1 Department of Surgery, Leiden University Medical Center , Leiden, The Netherlands .
authors.forename: Max B
authors.initials: MB
authors.lastname: van Gent
authors.affiliation: 2 Department of Medical Decision Making, Leiden University Medical Center , Leiden, The Netherlands .
authors.forename: Wendeline J
authors.initials: WJ
authors.lastname: van der Made
authors.affiliation: 2 Department of Medical Decision Making, Leiden University Medical Center , Leiden, The Netherlands .
authors.forename: Perla J
authors.initials: PJ
authors.lastname: Marang-van de Mheen
authors.affiliation: 1 Department of Surgery, Leiden University Medical Center , Leiden, The Netherlands .|3 Department of Surgery, Haaglanden Medical Center , The Hague, The Netherlands .
authors.forename: Koen E
authors.initials: KE
authors.lastname: van der Bogt
mesh_terms: D000293:Adolescent; D000328:Adult; D055499:Catheter-Related Infections / Q000453:epidemiology* / Q000382:microbiology*; D002405:Catheterization, Central Venous / Q000009:adverse effects* / Q000706:statistics & numerical data*; D062905:Central Venous Catheters / Q000382:microbiology; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D009426:Netherlands / Q000453:epidemiology; D012189:Retrospective Studies; D055815:Young Adult