Claire McNiven1, Noah Switzer2, Melisssa Wood1, Rabin Persad3, Marie Hancock4, Sarah Forgie5, Bryan J Dicken6. 1. Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB T6G 2B7, Canada. 2. Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB T6G 2B7, Canada; Department of Surgery, University of Alberta, Edmonton, AB T6G 2B7, Canada. 3. Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB T6G 2B7, Canada; Division of Pediatric Gastroenterology, University of Alberta, Edmonton, AB T6G 2B7, Canada. 4. Alberta Health Services, Home TPN Program University of Alberta, Edmonton, Alberta, Canada. 5. Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB T6G 2B7, Canada; Division of Pediatric Infectious Disease, University of Alberta, Edmonton, AB T6G 2B7, Canada. 6. Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB T6G 2B7, Canada; Division of Pediatric General Surgery, University of Alberta, Edmonton, AB T6G 2B7, Canada. Electronic address: bdicken@ualberta.ca.
Abstract
PURPOSE: The intestinal failure (IF) population is dependent upon central venous catheters (CVC) to maintain minimal energy requirements for growth. Central venous catheter infections (CVCI) are frequent and an independent predictor of intestinal failure associated liver disease. A common complication in children with long-term CVC is the risk of line breakage. Given the often-limited usable vascular access sites in this population, it has been the standard of practice to perform repair of the broken line. Although widely practiced, it is unknown if this practice is associated with increased line colonization rates and subsequent line loss. METHODS: A retrospective review of our institutional IF population over the past 8years (2006-2014) was performed. Utilizing a prospectively constructed database, all pediatric patients (n=13, ages 0-17 years) with CVC dependency enrolled in the Children's Intestinal Rehabilitation Program with IF were included who underwent a repair and/or replacement procedure of their line. The control replacement group was CVCs that were replaced without being repaired (36), the experimental repair group was CVCs that were repaired (8). The primary outcome of interest was the mean number of days in each group from the intervention (replacement or repair) to line infection/colonization. Mann-Whitney tests for significance were performed with p-values <0.05 being the threshold value for significance. RESULTS: There were no catheter repair associated CVCI. The mean number of days from the replacement or repair of a CVC to its removal owing to infection/colonization was 210.0 and 162.8days respectively. There was no statistically significant difference between these groups in time to removal owing to line infection (p=0.55). CONCLUSION: Repair of central venous catheters in the pediatric population with intestinal failure does not lead to an increased rate of central venous catheter infection and should be performed when possible.
PURPOSE: The intestinal failure (IF) population is dependent upon central venous catheters (CVC) to maintain minimal energy requirements for growth. Central venous catheter infections (CVCI) are frequent and an independent predictor of intestinal failure associated liver disease. A common complication in children with long-term CVC is the risk of line breakage. Given the often-limited usable vascular access sites in this population, it has been the standard of practice to perform repair of the broken line. Although widely practiced, it is unknown if this practice is associated with increased line colonization rates and subsequent line loss. METHODS: A retrospective review of our institutional IF population over the past 8years (2006-2014) was performed. Utilizing a prospectively constructed database, all pediatric patients (n=13, ages 0-17 years) with CVC dependency enrolled in the Children's Intestinal Rehabilitation Program with IF were included who underwent a repair and/or replacement procedure of their line. The control replacement group was CVCs that were replaced without being repaired (36), the experimental repair group was CVCs that were repaired (8). The primary outcome of interest was the mean number of days in each group from the intervention (replacement or repair) to line infection/colonization. Mann-Whitney tests for significance were performed with p-values <0.05 being the threshold value for significance. RESULTS: There were no catheter repair associated CVCI. The mean number of days from the replacement or repair of a CVC to its removal owing to infection/colonization was 210.0 and 162.8days respectively. There was no statistically significant difference between these groups in time to removal owing to line infection (p=0.55). CONCLUSION: Repair of central venous catheters in the pediatric population with intestinal failure does not lead to an increased rate of central venous catheter infection and should be performed when possible.
Authors: Kristine S Corkum; Rachel E Jones; Caroline H Reuter; Larry K Kociolek; Elaine Morgan; Timothy B Lautz Journal: Pediatr Surg Int Date: 2017-09-25 Impact factor: 1.827
Authors: Ludger Sieverding; Jörg Michel; Christian Urla; Ekkehard Sturm; Franziska Winkler; Michael Hofbeck; Jörg Fuchs; Johannes Hilberath; Steven Walter Warmann Journal: Front Nutr Date: 2022-03-28