![]() ![]() ![]() Hickman RO, Buckner CP, Clift RA, Sanders JE, Stewart P, Thomas ED (1979) A modified right atrial catheter for access to the venous system in marrow transplant recipients. Hartman GE, Shochat SJ (1987) Management of septic complications associated with silastic catheters in childhood malignancy. Surg Gynecol Obstet 154: 189–925įox AS, Boyer KM, Sweeney HM (1988) Antibiotic stability in a pediatric parenteral alimentation solution. Surg Clin North Am 66: 1197–1212įonakalsrud EW, Ament ME, Berquist WE, Burke M (1982) Occlusion of the vena cava in infants receiving central venous hyperalimentation. Surg Gynecol Obstet 136: 602–606Ĭoates TD, Rickard K, Grosfeld JL, Weetman RM (1986) Nutritional support of children with neoplastic diseases. Cancer 61: 376–376īroviac JW, Cole JJ, Scribner BH (1973) A silicone rubber atrial catheter for prolonged parenteral alimentation. complications in their choice of catheters and methods of insertion.īecton DL, Kletzel M, Golladay ES, Hathaway G, Berry DH (1988) An experience with an implanted port system in 66 children with cancer. Surgeons should balance the risks of convenience vs. These data indicate that percutaneously placed catheters and multilumen catheters are associated with significantly higher complication and infection rates. Bacterial infection cleared with antibiotics in 76% of cases with catheter sepsis, however secondary fungal infection necessitated prompt catheter removal. ![]() Temporary percutaneous catheters had a complication/infection rate 1.5 times greater than permanent catheters ( P < 0.05) that were operatively placed. Multiple-lumen catheters had twice the complication rate and infection rate of single lumen catheters ( P < 0.05). Despite the relatively high complication rate there were no catheter-related deaths. Catheter complications occurred in 107 (5%) cases, including symptomatic vessel thrombosis in 49, pneumothorax in 26, catheter migration in 25, vessel injury in 5, and catheter embolus in 2. aureus in 65, Klebsiella pneumoniae in 51, Escherichia coli in 51, and others in 18. Organisms included Staphylococcus epidermidis in 104 cases, Staph. Bacterial isolates were single in 125 cases and multiple in 86. Only 3 of 37 portacaths were removed because of infection. Forty-seven of 193 (24%) catheters were eventually removed because of persistent or recurrent infection (16 cases) or subsequent fungal sepsis due to Candida albicans (31 cases). Of 211 infected permanent catheters, 18 were immediately removed while 193 were treated with i.v. Of 219 infected temporary access catheters, 123 were removed while 96 were changed over a guide wire. Catheter infection occurred in 430 cases (18.8%). Indications for catheter insertion included emergency resuscitation or access (501), malignancy (462), and intestinal dysfunction (415). A single catheter was inserted in 542 cases and multiple catheters in 836. There were 1,012 temporary catheters (noncuffed/percutaneously placed) while 1,268 were inserted operatively, including 37 portacaths and 1,231 with dacron cuffs (Hickman, Broviac) for long-term use. Central venous catheters (n = 2,281) were placed in 1,378 children (728 boys:650 girls). This report evaluates the complications observed with the use of central venous catheters in 1,378 cases. Central venous access has become a frequent requirement in the management of seriously ill or injured infants and children with a wide variety of conditions. ![]()
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