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Thrombosis as a complication of central venous access in pediatric patients with malignancies: a 5-year single-center experience

BACKGROUND: Reliable central venous access (CVC) is essential for hematology–oncology patients since frequent puncture of peripheral veins—e.g., for chemotherapy, antibiotic administration, repeated blood sampling, and monitoring—can cause unacceptable pain and psychological trauma, as well as sever...

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Autores principales: Wiegering, Verena, Schmid, Sophie, Andres, Oliver, Wirth, Clemens, Wiegering, Armin, Meyer, Thomas, Winkler, Beate, Schlegel, Paul G, Eyrich, Matthias
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4195887/
https://www.ncbi.nlm.nih.gov/pubmed/25317335
http://dx.doi.org/10.1186/2052-1839-14-18
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author Wiegering, Verena
Schmid, Sophie
Andres, Oliver
Wirth, Clemens
Wiegering, Armin
Meyer, Thomas
Winkler, Beate
Schlegel, Paul G
Eyrich, Matthias
author_facet Wiegering, Verena
Schmid, Sophie
Andres, Oliver
Wirth, Clemens
Wiegering, Armin
Meyer, Thomas
Winkler, Beate
Schlegel, Paul G
Eyrich, Matthias
author_sort Wiegering, Verena
collection PubMed
description BACKGROUND: Reliable central venous access (CVC) is essential for hematology–oncology patients since frequent puncture of peripheral veins—e.g., for chemotherapy, antibiotic administration, repeated blood sampling, and monitoring—can cause unacceptable pain and psychological trauma, as well as severe side effects in cases of extravasation of chemotherapy drugs. However, CVC lines still carry major risk factors, including thrombosis, infection (e.g., entry site, tunnel, and luminal infections), and catheter dislocation, leakage, or breakage. METHODS: Here we performed a retrospective database analysis to determine the incidence of CVC-associated thrombosis in a single-center cohort of 448 pediatric oncologic patients, and to analyze whether any subgroup of patients was at increased risk and thus might benefit from prophylactic anticoagulation. RESULTS: Of the 448 patients, 269 consecutive patients received a CVC, and 55 of these 269 patients (20%) also had a thrombosis. Of these 55 patients, 43 had at least one CVC-associated thrombosis (total number of CVC-associated thrombosis: n = 52). Among all patients, the median duration of CVC exposure was 464 days. Regarding exposure time, no significant difference was found between patients with and without CVC-associated thrombosis. Subclavia catheters and advanced tumor stages seem to be the main risk factors for the development of CVC-associated thrombosis, whereas pharmacologic prophylaxis did not seem to have a relevant impact on the rate of thrombosis. CONCLUSIONS: We conclude that pediatric surgeons and oncologists should pay close attention to ensuring optimal and accurate CVC placement, as this appears the most effective tool to minimize CVC-associated complications.
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spelling pubmed-41958872014-10-15 Thrombosis as a complication of central venous access in pediatric patients with malignancies: a 5-year single-center experience Wiegering, Verena Schmid, Sophie Andres, Oliver Wirth, Clemens Wiegering, Armin Meyer, Thomas Winkler, Beate Schlegel, Paul G Eyrich, Matthias BMC Hematol Research Article BACKGROUND: Reliable central venous access (CVC) is essential for hematology–oncology patients since frequent puncture of peripheral veins—e.g., for chemotherapy, antibiotic administration, repeated blood sampling, and monitoring—can cause unacceptable pain and psychological trauma, as well as severe side effects in cases of extravasation of chemotherapy drugs. However, CVC lines still carry major risk factors, including thrombosis, infection (e.g., entry site, tunnel, and luminal infections), and catheter dislocation, leakage, or breakage. METHODS: Here we performed a retrospective database analysis to determine the incidence of CVC-associated thrombosis in a single-center cohort of 448 pediatric oncologic patients, and to analyze whether any subgroup of patients was at increased risk and thus might benefit from prophylactic anticoagulation. RESULTS: Of the 448 patients, 269 consecutive patients received a CVC, and 55 of these 269 patients (20%) also had a thrombosis. Of these 55 patients, 43 had at least one CVC-associated thrombosis (total number of CVC-associated thrombosis: n = 52). Among all patients, the median duration of CVC exposure was 464 days. Regarding exposure time, no significant difference was found between patients with and without CVC-associated thrombosis. Subclavia catheters and advanced tumor stages seem to be the main risk factors for the development of CVC-associated thrombosis, whereas pharmacologic prophylaxis did not seem to have a relevant impact on the rate of thrombosis. CONCLUSIONS: We conclude that pediatric surgeons and oncologists should pay close attention to ensuring optimal and accurate CVC placement, as this appears the most effective tool to minimize CVC-associated complications. BioMed Central 2014-10-01 /pmc/articles/PMC4195887/ /pubmed/25317335 http://dx.doi.org/10.1186/2052-1839-14-18 Text en © Wiegering et al.; licensee BioMed Central Ltd. 2014 This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Wiegering, Verena
Schmid, Sophie
Andres, Oliver
Wirth, Clemens
Wiegering, Armin
Meyer, Thomas
Winkler, Beate
Schlegel, Paul G
Eyrich, Matthias
Thrombosis as a complication of central venous access in pediatric patients with malignancies: a 5-year single-center experience
title Thrombosis as a complication of central venous access in pediatric patients with malignancies: a 5-year single-center experience
title_full Thrombosis as a complication of central venous access in pediatric patients with malignancies: a 5-year single-center experience
title_fullStr Thrombosis as a complication of central venous access in pediatric patients with malignancies: a 5-year single-center experience
title_full_unstemmed Thrombosis as a complication of central venous access in pediatric patients with malignancies: a 5-year single-center experience
title_short Thrombosis as a complication of central venous access in pediatric patients with malignancies: a 5-year single-center experience
title_sort thrombosis as a complication of central venous access in pediatric patients with malignancies: a 5-year single-center experience
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4195887/
https://www.ncbi.nlm.nih.gov/pubmed/25317335
http://dx.doi.org/10.1186/2052-1839-14-18
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