Long-term central venous access in a pediatric leukemia population

Aurelia B. Fu, Erica I. Hodgman, Lorraine S. Burkhalter, Rachel Renkes, Tamra Slone, Adam C. Alder

Research output: Contribution to journalArticle

1 Scopus citations

Abstract

Background Central venous access devices (CVADs) play an important role in the management of pediatric oncology patients; unfortunately, they are also associated with potentially serious complication rates. We hypothesized that, despite the significantly different disease courses typical of acute lymphoblastic leukemia and acute myelogenous leukemia, there would be identifiable risk factors for premature CVAD removal. Methods We retrospectively studied clinical characteristics and procedure records for all patients admitted with a leukemia diagnosis at our institution from May 2009 to July 2014. Results Our observed perioperative complication rate was 6%; over 70% of lines had at least one long-term complication (thrombosis, catheter-related bloodstream infection, or unexplained line malfunction). Obesity (odds ratio [OR], 6.9; 95% CI, 1.62-29.43), preoperative dosage of packed red blood cells (in mL/kg; OR, 3.13; 1.07-9.21), bloodstream infection (OR, 5.75; 1.69-19.56) were associated with increased risk of premature catheter removal; unexplained malfunction was associated with a lower risk (OR, 0.28; 0.09-0.93). Conclusions Obesity, the preoperative dosage of packed red blood cells, the presence of a bloodstream infection, and unexplained line malfunction are significant predictors of premature CVAD removal in a pediatric leukemia population.

Original languageEnglish (US)
Pages (from-to)419-425
Number of pages7
JournalJournal of Surgical Research
Volume205
Issue number2
DOIs
StatePublished - Oct 1 2016

Keywords

  • Central venous catheter
  • Complications
  • Pediatric
  • Vascular access

ASJC Scopus subject areas

  • Surgery
  • Medicine(all)

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