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Potential role of a subcutaneously anchored securement device in preventing dislodgment of tunneled-cuffed central venous devices in pediatric patients

Abstract

Introduction

The potential drawbacks of tunneled-cuffed catheters are complications such as local or systemic infection, dislodgment, rupture, malfunction, and deep venous thrombosis. Aim of this study is to describe the incidence of complications, focusing on dislodgment and on the role of new securement devices in reducing this annoying issue.

Methods

We enrolled all pediatric patients with tunneled-cuffed central venous catheters (CVCs) inserted at the Giannina Gaslini Institute during a 16-month period. Demographic data, technical details, intraoperative and postoperative complications were recorded and stored in a digital database according to Data Protection Act.

Results

During the study period, we collected 173 tunneled-cuffed CVCs. All but three insertions were successful. There were 50 complications involving 47 CVCs. Complications included 13 infections, 27 dislodgments, 4 thromboses, 3 obstructions, and 3 malfunctions/breaking. In 51 of 173 CVCs, we used subcutaneously anchored securement device (SAS).

Conclusions

The use of SAS proved to significantly reduce the incidence of complications in pediatric patients, particularly during the first 30 postoperative days. Basing on our results we suggest to routinely adopt this new securement device for high-risk CVC.

J Vasc Access 2017; 18(6): 540 - 545

Article Type: ORIGINAL RESEARCH ARTICLE

DOI:10.5301/jva.5000780

Authors

Andrea Dolcino, Antonio Salsano, Andrea Dato, Nicola Disma, Alessio Pini Prato, Filippo Bernasconi, Luigi Montagnini, Stefano Avanzini, Michela Bevilacqua, Giovanni Montobbio, Girolamo Mattioli, Clelia Zanaboni

Article History

Disclosures

Financial support: No grants or funding have been received for this study.
Conflict of interest: None of the authors has financial interest related to this study to disclose.

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Authors

Affiliations

  •  University of Genoa, Genoa - Italy
  •  Giannina Gaslini Institute, Genoa - Italy
  •  Department of Anaesthesia, Great Ormond Street Hospital, London - UK
  •  Antonio e Biagio e Cesare Arrigo Hospital, Alessandria - Italy
  •  University of Milan, Milan - Italy

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