Ceder H van den Bosch1, J Tjomme van der Bruggen2, Florine N J Frakking3, Cecilia E J Terwisscha van Scheltinga4, Cornelis P van de Ven5, Martine van Grotel6, Lianne M Wellens7, Yvette G T Loeffen8, Marta Fiocco9, Marc H W A Wijnen10. 1. Department of Pediatric Surgical Oncology, Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584, CS, Utrecht, The Netherlands. Electronic address: cedervandenbosch@gmail.com. 2. Department of Medical Microbiology, University Medical Center Utrecht, Heidelberglaan 100, 3584, CX, Utrecht, The Netherlands. Electronic address: j.t.vanderbruggen@umcutrecht.nl. 3. Department of Medical Microbiology, University Medical Center Utrecht, Heidelberglaan 100, 3584, CX, Utrecht, The Netherlands. Electronic address: f.n.j.frakking@umcutrecht.nl. 4. Department of Pediatric Surgical Oncology, Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584, CS, Utrecht, The Netherlands. Electronic address: C.E.J.TerwisschavanScheltinga@prinsesmaximacentrum.nl. 5. Department of Pediatric Surgical Oncology, Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584, CS, Utrecht, The Netherlands. Electronic address: c.p.vandeven-4@umcutrecht.nl. 6. Department of Pediatric Oncology, Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584, CS, Utrecht, The Netherlands. Electronic address: M.vanGrotel@prinsesmaximacentrum.nl. 7. Department of Pediatric Surgical Oncology, Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584, CS, Utrecht, The Netherlands. Electronic address: l.m.wellens@prinsesmaximacentrum.nl. 8. Department of Pediatric Infectious diseases and Immunology, Wilhelmina Children's Hospital, Lundlaan 6, 3584, EA, Utrecht, The Netherlands. Electronic address: Y.G.T.Loeffen-2@umcutrecht.nl. 9. Medical Statistics, Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584, CS, Utrecht, The Netherlands; Mathematical Institute, Niels Bohrweg 1, 2333, CA, Leiden, the Netherlands; Leiden University, Rapenburg 70, 2311, EZ, Leiden, the Netherlands; Department of Biomedical Data Sciences, Leiden University Medical Center, Einthovenweg 20, 2333, ZC, Leiden, The Netherlands. Electronic address: m.fiocco@lumc.nl. 10. Department of Pediatric Surgical Oncology, Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584, CS, Utrecht, The Netherlands. Electronic address: M.H.W.Wijnen-5@prinsesmaximacentrum.nl.
Abstract
BACKGROUND: Central venous access device (CVAD)-related complications are associated with high morbidity rates. This study was performed to underline the importance of CVAD-complication prevention and treatment. METHODS: An audit of practice of CVAD-related complications in pediatric oncology patients receiving a CVAD between January 2015 and June 2017 was performed. CVADs included were totally implantable venous access ports (TIVAPs), Hickman-Broviac® (HB), nontunneled, and peripherally inserted CVADs. RESULTS: A total of 201 children, with 307 CVADs, were analyzed. The incidence rates per 1000 CVAD-days for the most common complications were 1.66 for malfunctions, and 1.51 for central line-associated bloodstream infections (CLABSIs). Of all CVADs inserted, 37.1% were removed owing to complications, of which 45.6% were owing to CLABSIs. In 42% of the CLABSIs, the CLABSI could be successfully cured with systemic antibiotic treatment only. Of all included patients, 5.0% were admitted to the intensive care unit owing to CLABSI. The HB-CVAD compared to the TIVAP was a risk factor for CVAD-related complications, CLABSIs and dislocations in particular. CONCLUSIONS: The incidence of CVAD-related complications is high. Research on the prevention and treatment of CVAD-related complications in pediatric oncology patients should be a high priority for all health care professionals. TYPE OF STUDY: Prognosis study (retrospective). LEVEL OF EVIDENCE: Level II.
BACKGROUND: Central venous access device (CVAD)-related complications are associated with high morbidity rates. This study was performed to underline the importance of CVAD-complication prevention and treatment. METHODS: An audit of practice of CVAD-related complications in pediatric oncology patients receiving a CVAD between January 2015 and June 2017 was performed. CVADs included were totally implantable venous access ports (TIVAPs), Hickman-Broviac® (HB), nontunneled, and peripherally inserted CVADs. RESULTS: A total of 201 children, with 307 CVADs, were analyzed. The incidence rates per 1000 CVAD-days for the most common complications were 1.66 for malfunctions, and 1.51 for central line-associated bloodstream infections (CLABSIs). Of all CVADs inserted, 37.1% were removed owing to complications, of which 45.6% were owing to CLABSIs. In 42% of the CLABSIs, the CLABSI could be successfully cured with systemic antibiotic treatment only. Of all included patients, 5.0% were admitted to the intensive care unit owing to CLABSI. The HB-CVAD compared to the TIVAP was a risk factor for CVAD-related complications, CLABSIs and dislocations in particular. CONCLUSIONS: The incidence of CVAD-related complications is high. Research on the prevention and treatment of CVAD-related complications in pediatric oncology patients should be a high priority for all health care professionals. TYPE OF STUDY: Prognosis study (retrospective). LEVEL OF EVIDENCE: Level II.
Authors: Ceder H van den Bosch; Judith Spijkerman; Marc H W A Wijnen; Idske C L Kremer Hovinga; Friederike A G Meyer-Wentrup; Alida F W van der Steeg; Marianne D van de Wetering; Marta Fiocco; Indra E Morsing; Auke Beishuizen Journal: Support Care Cancer Date: 2022-07-01 Impact factor: 3.359
Authors: Matthew J Murray; Rafael Moleron; Jennifer Adamski; Martin English; G A Amos Burke; Justin Cross; Thankamma Ajithkumar; Sara Stoneham; James C Nicholson Journal: Pediatr Blood Cancer Date: 2021-09-14 Impact factor: 3.167