The authors explain the principle of central venous catheters (CVC) for long-term use, indicators for insertion, mode of insertion and principles of care of children with these special CVC. The authors inserted since 1982 42 CVC of the Broviac-Hickmann type in 32 children (age 22 days--15 years; body weight 2.4-17 kg). Since 1987 they inserted 16 CVC for long-term use with a subcutaneous capsule to 16 children and adolescents (age 1 years-17 years; body weight 11.5-73.5 kg). These CVC were inserted under general anaesthesia, in catheterization theatre. There were no technical complications. The authors treated and followed under standard protocol a group of 14 children with 20 CVC of the Broviac type (age at onset of treatment 22-715 days; body weight 2.4-10 kg) as well as the above described group of 16 children and adolescents with CVC for long-term use with a subcutaneous capsule. During treatment of children with Broviac catheters five technical complications were observed (mechanical damage of the CVC); in children with CVC with a subcutaneous capsule one technical complication was recorded (damage of the chamber of the Chemoport Vygon system, by incorrect puncture). The authors searched for thromboembolic and infectious complications. In four of 20 children with Broviac catheters purulent phlebitis of the cannulated veins was found (all died)--one thromboembolic complication developed on average after 234 days of use of Broviac catheters.(ABSTRACT TRUNCATED AT 250 WORDS)
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Kidney Med
November 2024
Graduate School of Medicine, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, NSW, Australia.
Rationale & Objective: Peritoneal dialysis (PD) is a dialysis modality limited by the potential need of transferring to hemodialysis. Optimal hemodialysis vascular access is an arteriovenous fistula. Back-up arteriovenous fistula (bAVF) is a strategy to prevent central venous catheter (CVC) insertion, but its use in the PD population has not been systematically reviewed.
View Article and Find Full Text PDFCase Rep Infect Dis
October 2024
Department of Cardiac Surgery, Józef Struś Hospital, Poznan, Poland.
Broviac catheter is a type of central venous catheter (CVC) used for long-term parenteral nutrition in specific patients, e.g., diagnosed with intestinal failure as short bowel syndrome (SBS).
View Article and Find Full Text PDFPaediatr Anaesth
January 2025
Division of Neonatology, Department of Paediatrics, Hacettepe University School of Medicine, Ankara, Turkey.
Background: Neonates are relatively prone to immediate, early, and late complications related to central venous cannulation (CVC). Ultrasound-guided brachiocephalic vein (BCV) cannulation has proven to be safe in neonates. Although studies addressed the immediate and early complications of CVC via BCV in neonates, few explored long-term maintenance-related complications.
View Article and Find Full Text PDFAnesthesiology
October 2024
Department of Anesthesiology, Children's Hospital of Chongqing Medical University, Chongqing 400014, China.
Background: The incidence of central venous catheter-related thrombosis and the long-term effects of thrombosis on catheterized veins in neonates is unknown. We therefore determined the incidence of central venous thrombosis, identified associated risk factors, and evaluated outcomes at 6 months.
Methods: We enrolled neonates aged less than 28 days scheduled for major intestinal or cardiac surgery whom we expected to require central venous catheters for at least 48 hours.
BMC Nephrol
October 2024
Division of Nephrology, Department of Medicine, University of the Philippines - Philippine General Hospital, 6th Floor, Ermita, Manila, 1000, Philippines.
Background: Despite efforts to improve the management of catheter-related bloodstream infections (CRBSI) in literature, temporary CVCs continue to be used for maintenance hemodialysis outside of acute care settings, particularly in the Philippines.
Methods: We conducted a retrospective cohort study to investigate the incidence, outcomes, risk factors, and microbiological patterns of CRBSI among adult kidney disease patients undergoing hemodialysis at the Philippine General Hospital, the country's largest tertiary referral center. We included all adult patients who received a CVC for hemodialysis from January 1, 2018, to August 31, 2019, and followed them for six months to observe the occurrence of CRBSI and its outcomes.
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