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Factors affecting mechanical complications of central venous access devices in children

PURPOSE: Factors leading to mechanical complications following insertion of central venous access devices (CVADs) in children are poorly understood. We aimed to quantify the rates and elucidate the mechanisms of these complications. METHODS: Retrospective (2016–2021) review of children (< 18 year...

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Autores principales: Zhang, Jessica J., Nataraja, Ramesh M., Lynch, Amiria, Barnes, Richard, Ferguson, Peter, Pacilli, Maurizio
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9163013/
https://www.ncbi.nlm.nih.gov/pubmed/35513517
http://dx.doi.org/10.1007/s00383-022-05130-1
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author Zhang, Jessica J.
Nataraja, Ramesh M.
Lynch, Amiria
Barnes, Richard
Ferguson, Peter
Pacilli, Maurizio
author_facet Zhang, Jessica J.
Nataraja, Ramesh M.
Lynch, Amiria
Barnes, Richard
Ferguson, Peter
Pacilli, Maurizio
author_sort Zhang, Jessica J.
collection PubMed
description PURPOSE: Factors leading to mechanical complications following insertion of central venous access devices (CVADs) in children are poorly understood. We aimed to quantify the rates and elucidate the mechanisms of these complications. METHODS: Retrospective (2016–2021) review of children (< 18 years old) receiving a CVAD. Data, reported as number of cases (%) and median (IQR), were analysed by Fisher’s exact test, chi-squared test and logistic regression analysis. RESULTS: In total, 317 CVADs (245 children) were inserted. Median age was 5.0 (8.9) years, with 116 (47%) females. There were 226 (71%) implantable port devices and 91 (29%) Hickman lines. Overall, 54 (17%) lines had a mechanical complication after 0.4 (0.83) years from insertion: fracture 19 (6%), CVAD migration 14 (4.4%), occlusion 14 (4.4%), port displacement 6 (1.9%), and skin tethering to port device 1 (0.3%). Younger age and lower weight were associated with higher risk of complications (p < 0.0001). Hickman lines had a higher incidence of complications compared to implantable port devices [24/91 (26.3%) vs 30/226 (13.3%); p = 0.008]. CONCLUSION: Mechanical complications occur in 17% of CVADs at a median of < 6 months after insertion. Risk factors include younger age and lower weight. Implantable port devices have a lower complications rate. LEVEL OF EVIDENCE: Level 4: case-series with no comparison group.
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spelling pubmed-91630132022-06-05 Factors affecting mechanical complications of central venous access devices in children Zhang, Jessica J. Nataraja, Ramesh M. Lynch, Amiria Barnes, Richard Ferguson, Peter Pacilli, Maurizio Pediatr Surg Int Original Article PURPOSE: Factors leading to mechanical complications following insertion of central venous access devices (CVADs) in children are poorly understood. We aimed to quantify the rates and elucidate the mechanisms of these complications. METHODS: Retrospective (2016–2021) review of children (< 18 years old) receiving a CVAD. Data, reported as number of cases (%) and median (IQR), were analysed by Fisher’s exact test, chi-squared test and logistic regression analysis. RESULTS: In total, 317 CVADs (245 children) were inserted. Median age was 5.0 (8.9) years, with 116 (47%) females. There were 226 (71%) implantable port devices and 91 (29%) Hickman lines. Overall, 54 (17%) lines had a mechanical complication after 0.4 (0.83) years from insertion: fracture 19 (6%), CVAD migration 14 (4.4%), occlusion 14 (4.4%), port displacement 6 (1.9%), and skin tethering to port device 1 (0.3%). Younger age and lower weight were associated with higher risk of complications (p < 0.0001). Hickman lines had a higher incidence of complications compared to implantable port devices [24/91 (26.3%) vs 30/226 (13.3%); p = 0.008]. CONCLUSION: Mechanical complications occur in 17% of CVADs at a median of < 6 months after insertion. Risk factors include younger age and lower weight. Implantable port devices have a lower complications rate. LEVEL OF EVIDENCE: Level 4: case-series with no comparison group. Springer Berlin Heidelberg 2022-05-05 2022 /pmc/articles/PMC9163013/ /pubmed/35513517 http://dx.doi.org/10.1007/s00383-022-05130-1 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Original Article
Zhang, Jessica J.
Nataraja, Ramesh M.
Lynch, Amiria
Barnes, Richard
Ferguson, Peter
Pacilli, Maurizio
Factors affecting mechanical complications of central venous access devices in children
title Factors affecting mechanical complications of central venous access devices in children
title_full Factors affecting mechanical complications of central venous access devices in children
title_fullStr Factors affecting mechanical complications of central venous access devices in children
title_full_unstemmed Factors affecting mechanical complications of central venous access devices in children
title_short Factors affecting mechanical complications of central venous access devices in children
title_sort factors affecting mechanical complications of central venous access devices in children
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9163013/
https://www.ncbi.nlm.nih.gov/pubmed/35513517
http://dx.doi.org/10.1007/s00383-022-05130-1
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