Thrombotic complications in children from short-term percutaneous central venous catheters: What can we do?

2014 ◽  
Vol 24 (9) ◽  
pp. 902-911 ◽  
Author(s):  
Gregory J. Latham ◽  
Douglas R. Thompson
Keyword(s):  
Central Venous Catheters ◽  
Central Venous ◽  
Short Term ◽  
Thrombotic Complications ◽  
Percutaneous Central Venous Catheters

Prospective Evaluation of Percutaneous Central Venous Silastic Catheters in Newborn Infants With Birth Weights of 510 o 3,920 Grams

PEDIATRICS ◽  
1986 ◽  
Vol 78 (2) ◽  
pp. 245-250 ◽  
Author(s):  
Manuel Durand ◽  
Rangasamy Ramanathan ◽  
Bruce Martinelli ◽  
Milagros Tolentino
Keyword(s):  
Parenteral Nutrition ◽  
Total Parenteral Nutrition ◽  
Very Low Birth Weight ◽  
Newborn Infants ◽  
Central Venous Catheters ◽  
Central Venous ◽  
Low Birth Weight Infants ◽  
A Prospective Study ◽  
First Time ◽  
Percutaneous Central Venous Catheters

With improved neonatal survival, especially of very low birth weight infants, our efforts should be directed toward reduction of morbidity. Sick preterm infants require total parenteral nutrition for prolonged periods of time due to extreme prematurity and feeding intolerance. However, the use of surgically placed Broviac catheters has been associated with a high complication rate. A prospective study of 53 percutaneous central venous Silastic catheterizations for administration of total parenteral nutrition was performed in 45 newborn infants. At the time of catheter insertion, 37 babies weighed less than 1,500 g and 19 weighed less than 1,000 g. Percutaneous central venous catheters were placed successfully the first time in 50 of 55 attempts. In three babies, insertion was successful on second attempt. The catheters remained in place for 25.4 ± 16.7 days ([mean ± SD] range two to 80 days). In babies weighing less than 1,000 g, the catheters remained in place for a longer period of time (34.0 ± 18.0; range 12 to 80 days). Sixty-six percent of the catheters were removed electively. There were four cases of bacteremia (7.5%), and the overall incidence of mechanical complications was 26.4%. We conclude that percutaneous central venous catheters can be used safely and effectively in newborn infants for prolonged administration of total parenteral nutrition, especially in neonates weighing less than 1,000 g.

Thrombus and thrombosis in cancer patients with permanent venous catheters

2000 ◽  
Vol 20 (03) ◽  
pp. 143-145
Author(s):  
H. D. Bruhn ◽  
F. Gieseler
Keyword(s):  
Risk Factors ◽  
Cancer Patients ◽  
Clinical Studies ◽  
Central Venous Catheters ◽  
Central Venous ◽  
Vascular Lumen ◽  
Additive Risk ◽  
Thrombotic Complications ◽  
Port Systems ◽  
Central Catheters

SummaryCancer patients have additive risk factors for thrombosis especially if permanent central catheters (port systems) are used for the delivery of chemotherapy. In our hospital the rate of thrombotic complications is below 5% for cancer patients receiving chemotherapy via port systems. This is in contrast to clinical studies, which have shown that up to 60% of catheters acquire clots that obstruct more than 50% of the vascular lumen. It is reasonable to believe that complications arising from thrombotic catheter alterations, such as bacterial hosting or micro-emboli, are clinically underestimated. The identification of thrombotic alterations of permanent central venous catheters in cancer patients receiving chemotherapy is substantial for the estimation whether anticoagulation strategies should be used as prophylaxis.

The Use of Temporary Central Venous Catheters for Optimizing Continuous Infusion in Hemophilia Patients Undergoing Major Surgical Procedures

Blood ◽  
2014 ◽  
Vol 124 (21) ◽  
pp. 2822-2822
Author(s):  
Ana Boban ◽  
Catherine M Lambert ◽  
Cedric R. Hermans
Keyword(s):  
Continuous Infusion ◽  
Surgical Procedures ◽  
Jugular Vein ◽  
Central Venous Catheters ◽  
Clotting Factor ◽  
Major Surgery ◽  
Peripheral Vein ◽  
Central Venous ◽  
Short Term ◽  
Factor Concentrate

Abstract Introduction: Continuous infusion (CI) of clotting factor concentrate has facilitated surgical procedures and intensive replacement therapy in hemophilia patients. The advantage of CI over bolus infusions is ability to maintain steady-state levels of coagulation factors and moreover, to reduce the total amount of factor concentrate spent. CI is commonly delivered through a peripheral vein. However, a significant number of hemophilia patients have distorted peripheral veins which can compromise continuous flow of factor concentrate needed for successful treatment. Also, thrombophlebitis at the site of venous access, an adverse effect of CI previously reported, can further impair the delivery of factor concentrate in CI and make the future use of the vein for concentrate administration impossible or difficult. Use of central venous catheter can ease the application of CI. By searching the literature, we found only a few case reports describing the use of temporary non-tunneled central venous catheters (CVC) for administrating CI in patients with hemophilia. The aim of this study was to evaluate the efficacy and safety of short-term used non-tunneled CVC for CI during surgical procedures in hemophilia patients. Methods: In this study we have retrospectively studied patients with hemophilia that had temporarily used non-tunneled CVC for CI of factor concentrate during and after major surgery in the Saint-Luc University Hospital in Brussels between August 2000 and April 2014. The indication for CVC usage was a major surgery with anticipated need for CI of factor concentrate longer than 5 days. CVC was inserted by an experienced anesthesiologist in the operating room after the induction of general anesthesia and normalization of APTT. Before the CVC insertion, the patient would have already received bolus of clotting factor concentrate and have the CI started through the peripheral vein. Upon placement, the CI was switched to the CVC. The CVC was kept in place until leaving hospital or cessation of the need for continuous infusion. Results: During the study period, 40 male patients with hemophilia A or B (37 and 3 patients, respectively) underwent 67 major surgical procedures covered by CI of factor concentrate delivered through CVC. Patients, age 21 -81, had severe, mild or moderate disease (33, 5 and 2 patients, respectively). Patients had altogether 65 CVC for 67 surgical procedures. The same catheter was used for 3 surgeries and 16 patients had CVC placed more than once; 14 patients twice, one patient three times and one ten times. Patients underwent orthopedic surgery (79%), gastrointestinal surgery (15%) and cardiovascular surgery (5%) while one patient (1%) had surgery of urinary tract. The CVC were placed in the right jugular vein (58%), the left jugular vein (18%), the left subclavian vein (8%) and right subclavian vein (3%), while the data were missing in 6 patients. Median duration of catheter was 12 days, with range from 5 to 107 days. No CVC was removed prematurely and no malfunctions of catheters were recorded. Moreover, no complications related to the CVC were noted whatsoever. We searched for bleeding at the site of puncture of the catheter, signs of local infection, pneumothorax following placement of CVC, catheter thrombosis, malfunction of the catheter and surgical site infection. Finally, most of the patients reported satisfaction related to the use of CVC for CI of factor concentrate. Conclusions: Based on results of this study, we can conclude that the use of short-term non-tunneled CVC should be considered in patients with hemophilia undergoing major surgery with the need for prolonged CI of factor concentrates. By placing CVC we can ensure undisturbed flow of factor concentrate during CI and preserve peripheral veins for the future concentrate administration. Disclosures No relevant conflicts of interest to declare.

Tunneling short-term central venous catheters to prevent catheter-related infection

1998 ◽  
Vol 26 (8) ◽  
pp. 1452-1457 ◽  
Author(s):  
Adrienne G. Randolph ◽  
Deborah J. Cook ◽  
Calle A. Gonzales ◽  
Christian Brun-Buisson
Keyword(s):  
Central Venous Catheters ◽  
Central Venous ◽  
Short Term ◽  
Catheter Related Infection

Clinical evaluation of a chlorhexidine intravascular catheter gel dressing on short-term central venous catheters

2016 ◽  
Vol 44 (1) ◽  
pp. 54-60 ◽  
Author(s):  
Tarja J. Karpanen ◽  
Anna L. Casey ◽  
Tony Whitehouse ◽  
Peter Nightingale ◽  
Ira Das ◽  
...  
Keyword(s):  
Clinical Evaluation ◽  
Central Venous Catheters ◽  
Intravascular Catheter ◽  
Central Venous ◽  
Short Term
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