OBJECTIVE: Identification of early mechanical complications (EMC) of central venous catheterizations (CVC) in pediatric patients and determination of EMC risk factors. DESIGN: Prospective observational study. SETTING: Pediatric intensive-care unit in a university hospital. PATIENTS AND MEASUREMENTS: Eight-hundred and twenty-five CVC were performed in 546 patients. Age, weight, gender, mechanical ventilation, analgesia, resident CVC failure, CVC indication, admission diagnosis, emergency or scheduled procedure, type of catheter (diameter, lumen number), catheter final location, number of attempts, and EMC were recorded. Risk factors for EMC were determined by multivariate analysis. RESULTS: Median patient age was 22.0 months (0-216 months). CVC was an emergency procedure in 421 (51%) cases, scheduled in 336 (40.7%), and guide-wire exchanged in 68 (8.2%). There were 293 (35.5%) internal jugular, 116 (14.1%) subclavian, and 416 (50.4%) femoral catheters. CVC was performed by staff physicians in 35.8% cases, supervised residents in 43.4%, and staff after resident failure in 20.8%. 151 EMC occurred in 144 CVC (17.5%). The most common EMC were arterial puncture (n = 60; 7.2%), catheter malposition (n = 39; 4.7%), arrhythmias (n = 19; 2.3%), and hematoma (n = 12; 1.4%). Resident failure to perform CVC (OR 2.53; CI 95% 1.53-4.16), high venous access (subclavian or jugular) (OR 1.91; CI 95% 1.26-2.88), and number of attempts (OR 1.10; CI 95% 1.03-1.17) were independently associated with EMC. CONCLUSIONS: EMC of CVC were common in a teaching university hospital, but severe complications were very uncommon. Resident failure to perform CVC, high venous access, and number of attempts were independent risk factors for EMC of CVC.
OBJECTIVE: Identification of early mechanical complications (EMC) of central venous catheterizations (CVC) in pediatric patients and determination of EMC risk factors. DESIGN: Prospective observational study. SETTING: Pediatric intensive-care unit in a university hospital. PATIENTS AND MEASUREMENTS: Eight-hundred and twenty-five CVC were performed in 546 patients. Age, weight, gender, mechanical ventilation, analgesia, resident CVC failure, CVC indication, admission diagnosis, emergency or scheduled procedure, type of catheter (diameter, lumen number), catheter final location, number of attempts, and EMC were recorded. Risk factors for EMC were determined by multivariate analysis. RESULTS: Median patient age was 22.0 months (0-216 months). CVC was an emergency procedure in 421 (51%) cases, scheduled in 336 (40.7%), and guide-wire exchanged in 68 (8.2%). There were 293 (35.5%) internal jugular, 116 (14.1%) subclavian, and 416 (50.4%) femoral catheters. CVC was performed by staff physicians in 35.8% cases, supervised residents in 43.4%, and staff after resident failure in 20.8%. 151 EMC occurred in 144 CVC (17.5%). The most common EMC were arterial puncture (n = 60; 7.2%), catheter malposition (n = 39; 4.7%), arrhythmias (n = 19; 2.3%), and hematoma (n = 12; 1.4%). Resident failure to perform CVC (OR 2.53; CI 95% 1.53-4.16), high venous access (subclavian or jugular) (OR 1.91; CI 95% 1.26-2.88), and number of attempts (OR 1.10; CI 95% 1.03-1.17) were independently associated with EMC. CONCLUSIONS: EMC of CVC were common in a teaching university hospital, but severe complications were very uncommon. Resident failure to perform CVC, high venous access, and number of attempts were independent risk factors for EMC of CVC.
Authors: M Angeles García-Teresa; Juan Casado-Flores; M Angel Delgado Domínguez; Jorge Roqueta-Mas; Francisco Cambra-Lasaosa; Andrés Concha-Torre; Cristina Fernández-Pérez Journal: Intensive Care Med Date: 2007-01-19 Impact factor: 17.440
Authors: Allison F Linden; Chase Corvin; Keva Garg; Richard R Ricketts; A Alfred Chahine Journal: Pediatr Surg Int Date: 2017-06-27 Impact factor: 1.827
Authors: Massimo Antonelli; Elie Azoulay; Marc Bonten; Jean Chastre; Giuseppe Citerio; Giorgio Conti; Daniel De Backer; François Lemaire; Herwig Gerlach; Goran Hedenstierna; Michael Joannidis; Duncan Macrae; Jordi Mancebo; Salvatore M Maggiore; Alexandre Mebazaa; Jean-Charles Preiser; Jerôme Pugin; Jan Wernerman; Haibo Zhang Journal: Intensive Care Med Date: 2010-02-23 Impact factor: 17.440
Authors: Ignacio Oulego-Erroz; Rafael González-Cortes; Patricia García-Soler; Mónica Balaguer-Gargallo; Manuel Frías-Pérez; Juan Mayordomo-Colunga; Ana Llorente-de-la-Fuente; Paula Santos-Herraiz; Juan José Menéndez-Suso; María Sánchez-Porras; Daniel Palanca-Arias; Carmen Clavero-Rubio; Mª Soledad Holanda-Peña; Luis Renter-Valdovinos; Sira Fernández-De-Miguel; Antonio Rodríguez-Núñez Journal: Intensive Care Med Date: 2017-12-01 Impact factor: 17.440
Authors: Maria J Santiago; Jesús López-Herce; Javier Urbano; María José Solana; Jimena del Castillo; Yolanda Ballestero; Marta Botrán; Jose María Bellón Journal: Crit Care Date: 2009-11-23 Impact factor: 9.097
Authors: Marie Heyne-Pietschmann; Dirk Lehnick; Johannes Spalinger; Franziska Righini-Grunder; Michael Buettcher; Markus Lehner; Martin Stocker Journal: Antibiotics (Basel) Date: 2021-11-29