Analysis of Complicationin Pediatric Patients with Hickman Catheters.
- Author:
Taehoon KIM
1
;
Dae Yeon KIM
;
Min Jeong CHO
;
Seong Chul KIM
;
In Koo KIM
Author Information
1. Department of Pediatric Surgery, Asan Medical Center, University of Ulsan College of medicine, Seoul, Korea. kimdy@amc.seoul.kr
- Publication Type:Original Article
- Keywords:
Hickman catheter;
Children;
Complications
- MeSH:
Anti-Bacterial Agents;
Catheters;
Central Venous Catheters;
Child;
Fluoroscopy;
Humans;
Multivariate Analysis;
Retrospective Studies
- From:Journal of the Korean Association of Pediatric Surgeons
2010;16(1):25-31
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Hickman catheters are tunneled central venous catheters used for long-term venous access in children with malignancies. The appropriate management for various kinds of catheter related complications has become a major issue. We retrospectively analyzed the clinical, demographic, and surgical characteristics in 154 pediatric hemato-oncology patients who underwent Hickman catheter insertion between January 2005 and December 2009. There were 92 boys and 62 girls. The mean age at surgery was 7.6+/-5.1 years old. The mean operation time was 67.4+/-21.3 minutes and C-arm fluoroscopy was used in 47(30.5%). The causes of Hickman catheter removal were termination of use in 82 (57.3%), catheter related bloodstream infection in 44(30.8%), mechanical malfunction in 11(7.7%), and accidents in 6(4.2%). Univariate and multivariate analysis for associated factors with catheter related bloodstream infection showed that there were no statistically significant associated factors with catheter related infection complications. All cases except two showed clinical improvement with catheter removal and relevant antibiotics treatment. The mean catheter maintenance period in patients of catheter removal without complications was 214.9+/-140.2 days. And, The mean catheter maintenance period in patients of late catheter related bloodstream infection was 198.0+/-116.0 days. These data suggest that it is important to remove Hickman catheter as soon as possible after the termination of use. When symptoms and signs of complications were noticed, prompt diagnostic approach and management can lead to clinical improvements.
