Central venous catheter–associated complications in pediatric patients diagnosed with Hodgkin lymphoma: implications for catheter choice
van den Bosch, Ceder H.; Spijkerman, Judith; Wijnen, Marc H.W.A.; Hovinga, Idske C.L.Kremer; Meyer-Wentrup, Friederike A.G.; van der Steeg, Alida F.W.; van de Wetering, Marianne D.; Fiocco, Marta; Morsing, Indra E.; Beishuizen, Auke
(2022) Supportive Care in Cancer, volume 30, issue 10, pp. 8069 - 8079
(Article)
Abstract
Purpose: The purpose of this study was to determine the most optimal central venous catheter (CVC) for pediatric patients with Hodgkin lymphoma (HL) in terms of complications. Methods: A retrospective study including patients diagnosed with HL from 2015 to 2021 at the Princess Máxima Center was performed. Patients were followed
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from CVC insertion until removal or 06–2021, whichever came first. The primary outcome was the CVC-related complication incidence rate (IR) per 1000 CVC-days. Furthermore, the incidence rate ratio (IRR) was calculated by comparing complication IRs between peripherally inserted central catheters (PICC) and totally implantable venous access ports (TIVAP). Additionally, risk factors for central venous thrombosis (CVT) were identified. Results: A total of 98 patients were included. The most frequently observed complications were local irritation/infections (18%; IR 0.93), malfunctions (15%; IR 0.88), and CVC-related CVTs (10%; IR 0.52). Single lumen PICCs were associated with a higher risk of complications (49% vs. 26%; IRR 5.12, CI95% 2.76–9.50), severe complications (19% vs. 7%; IRR 11.96, CI95% 2.68–53.42), and early removal (18% vs. 7%; IRR 9.96, CI95% 2.18–45.47). A single lumen PICC was identified as a risk factor for CVC-related CVT when compared to TIVAPs (12% vs. 7%, IRR 6.98, CI95% 1.45–33.57). Conclusion: The insertion of a TIVAP rather than a PICC should be recommended for pediatric patients with HL, especially in the presence of CVT-related risk factors. Future trials should evaluate the efficacy and safety of direct oral anticoagulants for the primary prevention of CVT in pediatric patients with a PICC and other CVT-related risk factors.
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Keywords: Central venous catheter, Complications, Hodgkin lymphoma, Pediatric, Thrombosis, Hodgkin Disease/complications, Venous Thrombosis/epidemiology, Anticoagulants, Catheterization, Peripheral/adverse effects, Thrombosis/etiology, Humans, Risk Factors, Catheter-Related Infections/epidemiology, Central Venous Catheters/adverse effects, Catheterization, Central Venous/adverse effects, Retrospective Studies, Child, Oncology, Journal Article
ISSN: 0941-4355
Publisher: Springer-Verlag
Note: Funding Information: We would like to acknowledge all patients and parents who gave permission to the use of their clinical data for research. Furthermore, we would like to acknowledge the Princess Máxima Center for Pediatric Oncology for the support of this research. Publisher Copyright: © 2022, The Author(s).
(Peer reviewed)