Prevalence of Symptomatic and Asymptomatic Thrombosis in Pediatric Oncology Patients With Tunneled Central Venous Catheters

2016 ◽  
Vol 63 (8) ◽  
pp. 1438-1444 ◽  
Author(s):  
Reineke A. Schoot ◽  
Marianne D. van de Wetering ◽  
Theo Stijnen ◽  
Wim J.E. Tissing ◽  
Erna Michiels ◽  
...  
Keyword(s):  
Pediatric Oncology ◽  
Central Venous Catheters ◽  
Central Venous ◽  
Oncology Patients

Bacteremia in nonneutropenic pediatric oncology patients with central venous catheters in the ED

2017 ◽  
Vol 35 (1) ◽  
pp. 20-24 ◽  
Author(s):  
Risha L. Moskalewicz ◽  
Leidy L. Isenalumhe ◽  
Cindy Luu ◽  
Choo Phei Wee ◽  
Alan L. Nager
Keyword(s):  
Pediatric Oncology ◽  
Central Venous Catheters ◽  
Central Venous ◽  
Oncology Patients

Central Venous Catheters and Venous Thrombotic Events in Pediatric Oncology Patients: A Multicenter Case Control Study

Blood ◽  
2012 ◽  
Vol 120 (21) ◽  
pp. 3400-3400
Author(s):  
Ketan P Kulkarni ◽  
Jacqueline Halton ◽  
Maria Spavor ◽  
Evan Shereck ◽  
Sara J. Israels ◽  
...  
Keyword(s):  
Cancer Survivors ◽  
Pediatric Oncology ◽  
Pediatric Cancer ◽  
Case Control Study ◽  
Case Control ◽  
Central Venous Catheters ◽  
Central Venous ◽  
Oncology Patients ◽  
The Mean ◽  
Control Study

Abstract Abstract 3400 Background: Central venous catheters (CVCs) have greatly improved the delivery of systemic chemotherapy to pediatric oncology patients and have significantly improved their quality of life. However, CVCs can cause serious venous thrombotic events (VTE), necessitating anticoagulation, CVC removal and reinsertion. There is paucity of data on clinical manifestations and impact of CVC associated VTE in pediatric cancer patients. In this study we describe the clinical presentation and impact of VTE on CVCs. Methods: We performed a multi-center case-control study in childhood cancer survivors. Survivors who experienced a symptomatic VTE during their therapy, and survivors who did not experience VTE (controls) were recruited. Additionally, controls in whom an asymptomatic VTE was detected were assessed separately. Data on location and number of CVCs and of VTE was analyzed. CVCs were categorized by method of insertion and included totally implanted devices (TID) such as ports, tunneled lines (TL) and peripherally insertion central catheters (PICC). Results: Seventy-seven survivors with a history of symptomatic VTE, 10 with asymptomatic VTE, and 178 controls were recruited (Table 1). The mean number of CVCs per individual cases and controls was 1.64±0.91 and 1.12±0.55, respectively (p=0.0001). In cases and controls, 44% and 12.3%, respectively, had >1 CVC (p=0.0001). In patients with asymptomatic VTE the mean number of CVCs per individual was 1.8±1.03 (p=0.069, tending towards significance as compared to controls); 50% had >1 CVC. Among cases with symptomatic VTE, right subclavian (RSCV) (35.1%), left subclavian (LSCV) (16.9%) and right internal jugular (RIJ) (14.3%) veins were the most common CVC sites. In controls, corresponding percentages were 32.6%, 20.8% and 9.6%, respectively. In patients with asymptomatic VTE, RIJ (40%) and RSCV (20%) were the most frequent CVC sites. TID, TL and PICC were used in 60.7%, 22.5% and 2.3% of the controls, respectively. The corresponding numbers in symptomatic VTE cases were 52%, 22.1% and 11.7%, respectively. The difference in distribution of CVCs in the 2 groups was statistically significant (p=0.017). TID were used more frequently in controls (60.7%) as compared to symptomatic VTE (52%) patients. Central venous catheters were inserted into the right-sided veins in 57.9%, 65% and 80% of the controls, symptomatic and asymptomatic VTE cases, respectively. Forty-nine patients had central venous VTE (CVVTE). CVC dysfunction (46.9%), swelling (34.7%) and pain (14.3%) were the most common symptoms of CVVTE. TID, TL and PICC were used in 50%, 34.8% and 6.5%, respectively, of the patients with CVVTE. Concordance in the location of CVC and CVVTE was seen in 27 (55.1%) cases. The most common sites of CVCs in these 27 patients were RIJ (25.9%), RSCV (25.9%) and LSCV (18.5%). Conclusions: In this cohort of pediatric cancer survivors, we made several novel observations indicating significant clinical impact of both symptomatic and asymptomatic VTE. The type of CVC used varied significantly between cases and controls. Use of TID appears protective, plausibly due to relatively shorter length of the central line (compared to other CVCs), non-exposed parts, and use of only non-coring needles to access the device. A concordance of over 50% in the location of CVCs and that of CVVTE was observed and has not previously been reported. These observations are of importance in identification of pediatric oncology patients at higher risk of CVC related complications. These observations can inform the design of appropriate preventive and therapeutic interventions in pediatric oncology patients who will continue to require CVCs. Disclosures: No relevant conflicts of interest to declare.

Blood Culture Accuracy: Discards From Central Venous Catheters in Pediatric Oncology Patients in the Emergency Department

2014 ◽  
Vol 40 (4) ◽  
pp. 323-329 ◽  
Author(s):  
Elizabeth J. Winokur ◽  
Debra Pai ◽  
Dana N. Rutledge ◽  
Kate Vogel ◽  
Sadeeka Al-Majid ◽  
...  
Keyword(s):  
Emergency Department ◽  
Blood Culture ◽  
Pediatric Oncology ◽  
Central Venous Catheters ◽  
Central Venous ◽  
Oncology Patients

Evaluation of Febrile, Nonneutropenic Pediatric Oncology Patients with Central Venous Catheters Who Are Not Given Empiric Antibiotics

2015 ◽  
Vol 166 (1) ◽  
pp. 157-162 ◽  
Author(s):  
Frederick Bartholomew ◽  
Catherine Aftandilian ◽  
Jennifer Andrews ◽  
Kathleen Gutierrez ◽  
Sandra Luna-Fineman ◽  
...  
Keyword(s):  
Pediatric Oncology ◽  
Central Venous Catheters ◽  
Not Given ◽  
Central Venous ◽  
Oncology Patients ◽  
Empiric Antibiotics

PROPHYLAXIS WITH UROKINASE IN PEDIATRIC ONCOLOGY PATIENTS WITH CENTRAL VENOUS CATHETERS

2002 ◽  
Vol 19 (3) ◽  
pp. 173-179 ◽  
Author(s):  
Maria Kalmanti ◽  
John Germanakis ◽  
Eftichia Stiakaki ◽  
Cathrin Sfyridaki ◽  
Athanasia Christidou ◽  
...  
Keyword(s):  
Pediatric Oncology ◽  
Central Venous Catheters ◽  
Central Venous ◽  
Oncology Patients

Central Venous Catheter-Associated Bloodstream Infections in Pediatric Oncology Home Care

2002 ◽  
Vol 23 (2) ◽  
pp. 99-101 ◽  
Author(s):  
Samir S. Shah ◽  
Mary Lou Manning ◽  
Elizabeth Leahy ◽  
Mark Magnusson ◽  
Susan R. Rheingold ◽  
...  
Keyword(s):  
Home Care ◽  
Pediatric Oncology ◽  
Bloodstream Infections ◽  
Venous Catheter ◽  
Home Care Services ◽  
Central Venous Catheters ◽  
Central Venous ◽  
Oncology Patients ◽  
Care Services ◽  
Gram Negative Organisms

AbstractFifty-two pediatric oncology patients with central venous catheters (CVCs) who received home care services were studied. Gram-negative organisms were responsible for a greater proportion of CVC-associated bloodstream infections in pediatric oncology patients receiving home care than in hospitalized pediatric oncology patients.

scholarly journals 580. Association Between Central Venous Catheter Repair and Bloodstream Infections in a Pediatric Oncology Center

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S274-S274
Author(s):  
Ruba Barbar ◽  
Hana Hakim ◽  
Patricia Flynn ◽  
Aditya H Gaur ◽  
Darenda Wright ◽  
...  
Keyword(s):  
Pediatric Oncology ◽  
Pediatric Population ◽  
Healthcare Delivery ◽  
Significant Risk ◽  
Bloodstream Infections ◽  
Categorical Variables ◽  
Central Venous ◽  
Oncology Patients ◽  
Increased Risk ◽  
Oncology Center

Abstract Background Central venous catheters (CVCs) are important for healthcare delivery in pediatric oncology patients. It is common to repair CVC breakage to prevent replacement. Existing evidence regarding the association between CVC repair and bloodstream infections (BSI) is limited in the general pediatric population and lacking in pediatric oncology patients. We aim at evaluating whether repairing broken CVCs is associated with an increased risk for subsequent BSI in a pediatric oncology center. Methods This is a retrospective case-crossover study of pediatric oncology patients with broken CVCs that underwent repair between July 2015 and June 2017. The incidence and characteristics of BSI in the 30-day pre-repair period were compared with those in the 30-day post-repair period. Wilcoxon-Mann–Whitney and Fisher’s Exact tests were used for comparison of continuous and categorical variables, respectively. Univariate logistic regression was used to identify potential risk factors for BSI post CVC repair. Multiple breakages of the same CVC, and BSIs in overlapping observation periods of consecutive breakages are assumed independent. Results Sixty-four patients had 99 episodes of CVC breakage/repair in 68 CVCs. Median age (range) at repair was 2.5 (0.15–17.6) years. 48% of CVC breakages occurred in patients with solid tumors, 24% in HSCT recipients, and 19% in patients with leukemia. Only 25% of patients had neutropenia at repair and 14% had CVC occlusion 72 hours prior to breakage. All CVCs were made of silicone and 88% were double lumen external tunneled. First CVC breakage occurred at a median (range) of 130 (2–718) days since insertion, and CVCs were removed at a median (range) of 72.5 (3–753) days from the last repair. End of treatment was the most common cause (43%) for removal. The post-repair incidence of BSI was 4.5 per 1000 line-days compared with a pre-repair incidence of 4.3 (RR= 0.95, 95% CI 0.44, 2.18). There is no statistical difference between the characteristics of the pre-repair and post-repair BSI (Table 1). Figure 1 shows the organisms causing BSI before and after CVC repair. None of the evaluated variables was identified as a significant risk factor for BSI 30 days after CVC repair (Table 2). Conclusion Repair of CVC in pediatric oncology patients was not associated with increased risk of BSI. Disclosures All authors: No reported disclosures.

Sign in / Sign up

Export Citation Format

Share Document