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Mechanical complications of central venous catheters in children: A cohort study

Published online by Cambridge University Press:  21 December 2021

Kieran J. Moore Open the ORCID record for Kieran J. Moore [Opens in a new window] ,
David Greencorn Open the ORCID record for David Greencorn [Opens in a new window] ,
Nadine Smith ,
Joanne M. Langley Open the ORCID record for Joanne M. Langley [Opens in a new window]  and
Ketan Kulkarni Open the ORCID record for Ketan Kulkarni [Opens in a new window]
Kieran J. Moore
Affiliation:
Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
David Greencorn
Affiliation:
Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
Nadine Smith
Affiliation:
Department of Surgery, IWK Health Centre, Halifax, Nova Scotia, Canada
Joanne M. Langley
Affiliation:
Department of Pediatrics, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada Department of Community Health and Epidemiology, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada Division of Infectious Diseases, IWK Health Centre, Halifax, Nova Scotia, Canada
Ketan Kulkarni*
Affiliation:
Department of Pediatrics, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada Division of Hematology and Oncology, IWK Health Centre, Halifax, Nova Scotia, Canada
*
Author for correspondence: Dr Ketan Kulkarni, E-mail: ketan.kulkarni@iwk.nshealth.
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Abstract

Background:

Despite the numerous advantages of central venous catheters (CVCs), they have been associated with a variety of complications. Surveillance for mechanical complications of CVCs is not routine, so the true incidence and impact of this adverse patient outcome remains unclear.

Setting and methods:

Prospectively collected CVC data on mechanical complications were reviewed from a centralized database for all in-hospital patient days at our tertiary-care hospital from January 2001 to June 2016 in patients aged <19 years. Patient demographics, CVC characteristics, and rates of mechanical complications per 1,000 days of catheter use were described.

Results:

In total, 8,747 CVCs were placed in 5,743 patients during the study period, which captured 780,448 catheter days. The overall mechanical complication rate was 6.1 per 1,000 catheter days (95% confidence interval [CI], 5.9–6.3). The highest complication rates were in nontunneled lines; this was consistent throughout the 15-year study period. Also, 521 CVCs (∼6%) were removed due to mechanical complications before therapy termination. Catheters with tip location in the superior vena cava or right atrium had the fewest complications.

Conclusions:

Mechanical complications of CVCs are a common and significant event in the pediatric population. We propose that CVC-associated mechanical complications become a routinely reported patient safety outcome.

Type
Original Article
Information
Infection Control & Hospital Epidemiology , Volume 43 , Issue 11 , November 2022 , pp. 1634 - 1640
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Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of The Society for Healthcare Epidemiology of America

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Footnotes

PREVIOUS PRESENTATION. These data were accepted for poster presentation at the Pediatric Society National Meeting on June 5, 2021, in Vancouver, BC, but the meeting was cancelled due to the COVID-19 pandemic. These data were presented virtually at the Nova Scotia IWK Pediatric Research Day on DATE HERE.

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