Cesaro Simone, Corrò Roberta, Pelosin Anna, Gamba Piergiorgio, Zadra Nicola, Fusaro Fabio, Pillon Marta, Cusinato Riccardo, Zampieri Chiara, Magagna Laura, Cavaliere Mara, Tridello Gloria, Zanon Gianfranco, Zanesco Luigi
Department of Pediatrics, Clinic of Pediatric Hematology Oncology, University of Padova, Via Giustiniani 3, 35128, Padova, Italy.
Ann Hematol. 2004 Mar;83(3):183-8. doi: 10.1007/s00277-003-0796-9. Epub 2003 Nov 13.
A prospective pediatric survey on the incidence of central venous catheter (CVC) complications was performed aimed at identifying risk factors of premature CVC removal. The study comprised 129 Broviac-Hickman CVCs inserted during a 13-month period in 112 children. The total number of CVC days was 19,328 (median: 122 days, range: 1-385). The overall rate of complications was 6.2/1000 CVC days, i.e., 4.5/1000 and 1.7/1000 CVC days for mechanical and infectious complications, respectively. Interestingly, only two CVC-related cases of septicemia and no thrombotic events were documented. At the end of the study period, 38 of 129 CVC (29.5%) had been removed: 20 due to CVC-related complications (dislocation18, rupture 2), 10 due to the patient's death, and 8 due to completion of therapy. Age at CVC insertion <4.9 years was a significant predictor of premature CVC removal ( p=0.01). Mechanical complications, especially in younger children, are the main cause of premature loss of CVC. These data underline the importance of more effectively securing the CVC to subcutaneous tissue in pediatric patients to reduce accidental dislocations.
一项关于中心静脉导管（CVC）并发症发生率的前瞻性儿科调查旨在确定过早拔除CVC的危险因素。该研究纳入了112名儿童在13个月期间插入的129根Broviac-Hickman CVC。CVC留置总天数为19328天（中位数：122天，范围：1 - 385天）。并发症总发生率为6.2/1000 CVC留置日，即机械性并发症和感染性并发症的发生率分别为4.5/1000和1.7/1000 CVC留置日。有趣的是，仅记录到2例与CVC相关的败血症病例，未记录到血栓形成事件。在研究期结束时，129根CVC中有38根（29.5%）已拔除：20根因CVC相关并发症（移位18根，破裂2根），10根因患者死亡，8根因治疗结束。CVC插入时年龄<4.9岁是过早拔除CVC的显著预测因素（p = 0.01）。机械性并发症，尤其是在年幼儿童中，是CVC过早丢失的主要原因。这些数据强调了在儿科患者中更有效地将CVC固定至皮下组织以减少意外移位的重要性。
