Mechanical complications related to indwelling central venous catheter in pediatric hematology/oncology patients.

Indwelling central venous catheters (CVC) are essential devices in the management of children with oncologic/hematologic diseases or following bone marrow transplantation. The authors report data on the mechanical complications observed in pediatric hematology/oncology patients, collected by a retrospective analysis of clinical records of 482 patients in whom 567 indwelling central venous catheters had been inserted from January 1992 to December 1998 at the G. Gaslini Institute. During the study period, 52 episodes of mechanical complications (9%) were observed: mechanical obstruction (24 episodes), catheter dislocation (13), problems related to catheter material (12), and accidental removal (3). In 25 cases removal and replacement of CVC was necessary for the treatment of complications, while medical treatment (thrombolytic-antithrombotic) was successful and well tolerated in 8. The study shows the importance of mechanical complications in children with indwelling CVC for hematologic or oncologic diseases. Moreover, the experience of administering a systemic low-dosage thrombolytic therapy demonstrates new prospects of reducing CVC replacement by restoring CVC viability.