Department of Radiology, Children's Hospital of Philadelphia, 3401 Civic Center Blvd., Philadelphia, PA 19014.
Department of Radiology, Children's Hospital of Philadelphia, 3401 Civic Center Blvd., Philadelphia, PA 19014.
J Vasc Interv Radiol. 2018 Apr;29(4):492-496. doi: 10.1016/j.jvir.2017.10.017. Epub 2018 Jan 17.
To evaluate technical success and the incidences of, and risk factors for, mechanical and infectious complications of venous port placement in infants.
This was a retrospective single-institution cohort study of port placement in infants (age < 1 y) from January 2006 through June 2016 (mean age, 7.5 mo ± 3.3; mean weight, 8.1 kg ± 1.9). Age, weight, sex, side of placement, tip position, and indication for placement (chemotherapy vs other) were recorded. Total catheter-days (CDs), mechanical complications, and central catheter-associated bloodstream infections (CCABSIs) were identified.
During the study years, 64 ports were placed in 64 infants, with a technical success rate of 100%. The mean catheter life was 321 days (total range, 4-1,917 d; interquartile range [IQR], 107-421 d). There were 13 CCABSI events (0.63 per 1,000 CDs); of these, 8 (12.5% among 64 patients) required port removal for infection. There was an increase in CCABSIs in patients with left-sided port placement (relative risk [RR], 3.22; 95% confidence interval [CI], 1.02-10.14; P = .05). There were 8 mechanical complications of the port reservoir or catheter (0.39 per 1,000 CDs). Of these, 2 (3.1%) required removal. Patients in the lowest weight quartile were at an increased risk of mechanical complications (RR, 4.37; 95% CI, 1.09-17.48; P = .04).
Venous ports can be placed with a high rate of technical success in infants. Left-sided ports and low weight are associated with increased infectious and mechanical complications, respectively.
评估静脉港在婴儿（年龄<1 岁）中的技术成功率，以及机械和感染并发症的发生率和危险因素。
这是一项回顾性单机构队列研究，纳入了 2006 年 1 月至 2016 年 6 月期间接受静脉港置入的婴儿（年龄<1 岁）（平均年龄 7.5 个月±3.3；平均体重 8.1 千克±1.9）。记录年龄、体重、性别、置管侧、尖端位置以及置管适应证（化疗 vs 其他）。确定总导管天数（CD）、机械并发症和中心静脉导管相关血流感染（CCABSI）。
在研究期间，共对 64 例婴儿的 64 个静脉港进行了置管，技术成功率为 100%。平均导管留置时间为 321 天（总范围 4-1917 天；四分位距 [IQR] 107-421 天）。发生 13 例 CCABSI 事件（每 1000 CD 发生 0.63 例）；其中 8 例（64 例患者中的 12.5%）因感染需要拔除静脉港。左侧置管的患者发生 CCABSI 的风险增加（相对风险 [RR] 3.22；95%置信区间 [CI] 1.02-10.14；P=0.05）。静脉港储液器或导管发生 8 例机械并发症（每 1000 CD 发生 0.39 例），其中 2 例（3.1%）需要拔除。体重处于最低四分位数的患者发生机械并发症的风险增加（RR 4.37；95%CI 1.09-17.48；P=0.04）。
在婴儿中，静脉港可以以高的技术成功率进行置管。左侧置管和低体重分别与感染和机械并发症的增加相关。
