Incidents and complications of totally implanted vascular access devices in children: a prospective study.

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Serval ID
serval:BIB_7A786E430BAF
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Incidents and complications of totally implanted vascular access devices in children: a prospective study.
Journal
Patient Safety in Surgery
Author(s)
Tercier S., Gapany C., Diezi M., Clément C., Lemay K., Joseph J.M.
ISSN
1754-9493 (Electronic)
ISSN-L
1754-9493
Publication state
Published
Issued date
2008
Peer-reviewed
Oui
Volume
2
Number
30
Pages
1-5
Language
english
Notes
Publication types: Journal Article
Publication Status: epublish
Abstract
BACKGROUND: Totally implanted vascular access devices are frequently used in children for repeated blood samples or intravenous treatments. This prospective study aims at identifying the risk factors associated with infections, obstructions and surgical complications of these devices in pediatric patients.
METHODS: From January 2006 to January 2008, all children older than one year of age with a diagnosis of solid or blood cell malignancy were included in the study. Insertion was performed by the surgeon according to a standardized protocol after landmark-guided puncture of the subclavian or internal jugular vein by a senior anesthesiologist. Dressing and post-operative care were standardized. Every manipulation was prospectively recorded by specialized dedicated nurses, and all patients were screened for complications one month post-surgery.
RESULTS: 45 consecutive patients 1 to 16 years old were enrolled in the study. Mean age at the time of procedure was 8.5 years (range 1.3-15.6; SD +/- 4.88). There were 12 peroperative adverse events in 45 procedures (27%), detailed as follows: 3 pneumothoraces (7%), 3 hematomas (7%), 6 arterial punctures (13%). Among these events, intervention was necessary for two pneumothorax and one arterial puncture. There was no air embolism. At one month, we recorded 5 post-operative complications (11%): 2 thrombotic obstructions, one unsightly scar, and one scapular pain of unknown etiology. One patient needed repositioning of the catheter. There was no catheter-related infection.
CONCLUSION: Prospective recording of TIVA insertion in children reveals a significant number of early incidents and complications, mainly associated with the percutaneous puncture technique. We found no infection in this series. Results of a longer follow-up in the same population are pending.
Pubmed
Open Access
Yes
Create date
11/02/2009 12:43
Last modification date
20/08/2019 15:36
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