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Central venous access devices in children with congenital coagulation disorders: Complications and long-term outcome


, : Central venous access devices in children with congenital coagulation disorders: Complications and long-term outcome. British Journal of Haematology 110(2): 461-468, August

Reliable venous access is essential to facilitate the administration of prophylactic factor concentrate or blood products in children with congenital coagulation disorders and immune tolerance therapy (ITT) regimens in those who develop high responding inhibitors. Poor venous access is even more problematic in very young children, the vast majority of whom will require the insertion of central venous access devices (CVADs). Previous studies have suggested that infection rates are low and that there are few long-term complications associated with CVAD usage. We have reviewed 86 CVADs that have been inserted, since 1988, in 58 children with congenital bleeding disorders, aged 6 d to 16.5 years, attending Great Ormond Street Hospital, London, and the National Children's Hospital, Dublin. The devices have remained in situ for 2 weeks to 92 months (median 22.5 months). Early (0-2 weeks) complications of CVAD insertion included nine bleeding episodes, one extravasation of factor concentrate, three allergic reactions to factor concentrate and five catheter infections. Overall, CVAD infection was the commonest problem encountered, with 52 devices (60%) becoming infected. Twenty-seven CVADs (31%) required removal. Infection rates in children without inhibitors (29/68) were 1/20 patient-months or 1. 6 infections/1000 patient-days, but infection rates for those with inhibitors were 1/8.5 patient-months or 4.3/1000 patient-days. Staphylococcus epidermidis was the predominant organism (25/52) isolated. Blockage of CVAD (four) and catheter disconnection (four) were the most frequently occurring non-infectious long-term complications. Skin erosion of the port was also seen in three children, in one child at 20 months, in one at 29 months and in one at 34 months after insertion. This study demonstrates a high CVAD infection rate and highlights the long-term complications of CVAD usage.

US$19.90

PMID: 10971409

DOI: 10.1046/j.1365-2141.2000.02184.x


Other references

Atapattu, R.; Samarajeewa, U., 1990: Fungi associated with dried fish in Sri Lanka. The mycoflora of dried-salted fish from markets in Kandy, Sri Lanka was studied with emphasis on visibly spoiled dried fish. A total of 61 fungal isolates from 25 dried-fish were isolated and identified. The most prevalent fungus was Aspergillus n...

Tanabe, K.; Yokochi, F.; Hirai, S.; Mori, H.; Suda, K.; Kondo, T.; Mizuno, Y., 1994: A 75-year-old man with parkinsonism and delirium. We report a 75-year-old man with a ten-year history of parkinsonism, who developed acute delirium. He was well until 65 years of age, when there was an onset of tremor in his left hand. He had been treated with levodopa and trihexyphenidyl with ma...

Bame S.J., 1968: Plasma sheet and adjacent regions. Pages 373-383 1968

Husser, J.A.; Traore, I.; Daumerie, D., 1994: Activity of two doses of rifampin against Mycobacterium leprae. In the course of a clinical trial designed to re-examine the bactericidal efficiency of 600-mg doses of rifampin (RMP) against Mycobacterium leprae, two doses of RMP, either 600 mg or 1200 mg, were administered 28 days apart to 29 previously untre...

Demaria, J.E.; Nagy, G.M.; Lerant, A.A.; Fekete, M.I.E.; Levenson, C.W.; Freeman, M.E., 2000: Dopamine transporters participate in the physiological regulation of prolactin. Three populations of hypothalamic neuroendocrine dopaminergic (NEDA) neurons, arising from the arcuate and periventricular nuclei of the hypothalamus release dopamine (DA) that acts at the pituitary gland to regulate the secretion of prolactin (PR...

Sadeghipour, H.; Ghasemi, M.; Nobakht, M.; Ebrahimi, F.; Dehpour, A.Reza., 2006: Effect of chronic lithium administration on endothelium-dependent relaxation of rat corpus cavernosum: the role of nitric oxide and cyclooxygenase pathways. OBJECTIVE To verify the effect of chronic lithium administration on the endothelium-dependent relaxation of rat corpus cavernosum, as lithium is a major drug for treating bipolar disorder and some studies showed that lithium might cause erectile...

Crew, F.A.E., 1922: A Black Leghorn which turned White. Journal of Heredity Washington, 13: 299-303

Anderson, L.W.J.; Sweeney, B.M., 1977: Diel changes in sedimentation characteristics of ditylum brightwelli changes in cellular lipid and effects of respiratory inhibitors and ion transport modifiers. Temperature-controlled seawater columns were used to investigate settling rates of D. brightwelli grown on light-dark schedules. Ficoll density gradient centrifugation was used to examine effects of KCN, DNP [dinitrophenol], and the ion-transport...

Wang, J.; Liu, G.; Zhang, J.; Liu, H.; Lam, P.K.S., 2016: A 59-year sedimentary record of metal pollution in the sediment core from the Huaihe River, Huainan, Anhui, China. NlmCategory="UNASSIGNED">An approximately 59-year (1955-2014) sedimentary record of metal elements (Cu, Pb, Zn, Ni, Co, Mn, and Fe) in a sediment core, collected from the Huaihe River, Huainan City, Anhui Province, China, was reconstr...

Sarles, H.; Guigou, C., 1952: Pancreatitis and primary chronic papillitis. La Semaine des Hopitaux 27(82): 3266-3276