Complications and its risk factors of percutaneous subclavian vein catheters in pediatric patients: enhancing the outcomes of a university hospital in a low-income and middle-income country
Objective Assessing central venous catheter-related complications with regular feedback and investigating risk factors are mandatory to enhance outcomes. The aim of this study is to assess our experience in the management of pediatric subclavian vein catheters (SVCs) and to investigate the main risk...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2023-02-01
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| Series: | World Journal of Pediatric Surgery |
| Online Access: | https://wjps.bmj.com/content/6/1/e000523.full |
| _version_ | 1797894893572456448 |
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| author | Saloua Ammar Anouar Jarraya Manel Kammoun Ameni Chtourou Kamel Kolsi |
| author_facet | Saloua Ammar Anouar Jarraya Manel Kammoun Ameni Chtourou Kamel Kolsi |
| author_sort | Saloua Ammar |
| collection | DOAJ |
| description | Objective Assessing central venous catheter-related complications with regular feedback and investigating risk factors are mandatory to enhance outcomes. The aim of this study is to assess our experience in the management of pediatric subclavian vein catheters (SVCs) and to investigate the main risk factors for complications.Methods In this prospective observational study, we included children aged 3 months to 14 years who underwent infraclavicular subclavian vein catheterization consecutively using the anatomic landmark technique. Patients were divided into two groups: group 1 included complicated catheters and group 2 included non-complicated catheters. The management protocol was standardized for all patients. After comparing the two groups, univariate and multivariate logistic regression were used to investigate the risk factors for complications.Results In this study, we included 134 pediatric patients. The rate of complications was 32.8%. The main complications were central line-associated bloodstream infection (63.6%), bleeding and/or hematoma (22.7%), mechanical complications (13.6%), and vein thrombosis (13.6%). After adjustment for confounding factors, predictors of catheter-related complications were difficult insertion procedure (adjusted odds ratio (aOR)=9.4; 95% confidential interval (CI): 2.32 to 38.4), thrombocytopenia (aOR=4.43; 95% CI: 1.16 to 16.86), comorbidities (aOR=2.93; 95% CI: 0.58 to 14.7), and neutropenia (aOR=5.45; 95% CI: 2.29 to 13.0).Conclusions High rates of complications were associated with difficult catheter placement and patients with comorbidities and severe thrombocytopenia. To reduce catheter-related morbidity, we suggest an ultrasound-guided approach, a multidisciplinary teaching program to improve nursing skills, and the use of less invasive devices for patients with cancer. |
| first_indexed | 2024-04-10T07:16:35Z |
| format | Article |
| id | doaj.art-bdc4d40fa695448f885837581bfc8834 |
| institution | Directory Open Access Journal |
| issn | 2516-5410 |
| language | English |
| last_indexed | 2024-04-10T07:16:35Z |
| publishDate | 2023-02-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | World Journal of Pediatric Surgery |
| spelling | doaj.art-bdc4d40fa695448f885837581bfc88342023-02-25T06:30:10ZengBMJ Publishing GroupWorld Journal of Pediatric Surgery2516-54102023-02-016110.1136/wjps-2022-000523Complications and its risk factors of percutaneous subclavian vein catheters in pediatric patients: enhancing the outcomes of a university hospital in a low-income and middle-income countrySaloua Ammar0Anouar Jarraya1Manel Kammoun2Ameni Chtourou3Kamel Kolsi4Department of Pediatric Surgery, Hedi Chaker Hospital, Sfax, TunisiaThe Anesthesiology department, University of Sfax Faculty of Medicine of Sfax, Sfax, TunisiaThe Anesthesiology department, University of Sfax Faculty of Medicine of Sfax, Sfax, TunisiaThe Anesthesiology department, University of Sfax Faculty of Medicine of Sfax, Sfax, TunisiaThe Anesthesiology department, University of Sfax Faculty of Medicine of Sfax, Sfax, TunisiaObjective Assessing central venous catheter-related complications with regular feedback and investigating risk factors are mandatory to enhance outcomes. The aim of this study is to assess our experience in the management of pediatric subclavian vein catheters (SVCs) and to investigate the main risk factors for complications.Methods In this prospective observational study, we included children aged 3 months to 14 years who underwent infraclavicular subclavian vein catheterization consecutively using the anatomic landmark technique. Patients were divided into two groups: group 1 included complicated catheters and group 2 included non-complicated catheters. The management protocol was standardized for all patients. After comparing the two groups, univariate and multivariate logistic regression were used to investigate the risk factors for complications.Results In this study, we included 134 pediatric patients. The rate of complications was 32.8%. The main complications were central line-associated bloodstream infection (63.6%), bleeding and/or hematoma (22.7%), mechanical complications (13.6%), and vein thrombosis (13.6%). After adjustment for confounding factors, predictors of catheter-related complications were difficult insertion procedure (adjusted odds ratio (aOR)=9.4; 95% confidential interval (CI): 2.32 to 38.4), thrombocytopenia (aOR=4.43; 95% CI: 1.16 to 16.86), comorbidities (aOR=2.93; 95% CI: 0.58 to 14.7), and neutropenia (aOR=5.45; 95% CI: 2.29 to 13.0).Conclusions High rates of complications were associated with difficult catheter placement and patients with comorbidities and severe thrombocytopenia. To reduce catheter-related morbidity, we suggest an ultrasound-guided approach, a multidisciplinary teaching program to improve nursing skills, and the use of less invasive devices for patients with cancer.https://wjps.bmj.com/content/6/1/e000523.full |
| spellingShingle | Saloua Ammar Anouar Jarraya Manel Kammoun Ameni Chtourou Kamel Kolsi Complications and its risk factors of percutaneous subclavian vein catheters in pediatric patients: enhancing the outcomes of a university hospital in a low-income and middle-income country World Journal of Pediatric Surgery |
| title | Complications and its risk factors of percutaneous subclavian vein catheters in pediatric patients: enhancing the outcomes of a university hospital in a low-income and middle-income country |
| title_full | Complications and its risk factors of percutaneous subclavian vein catheters in pediatric patients: enhancing the outcomes of a university hospital in a low-income and middle-income country |
| title_fullStr | Complications and its risk factors of percutaneous subclavian vein catheters in pediatric patients: enhancing the outcomes of a university hospital in a low-income and middle-income country |
| title_full_unstemmed | Complications and its risk factors of percutaneous subclavian vein catheters in pediatric patients: enhancing the outcomes of a university hospital in a low-income and middle-income country |
| title_short | Complications and its risk factors of percutaneous subclavian vein catheters in pediatric patients: enhancing the outcomes of a university hospital in a low-income and middle-income country |
| title_sort | complications and its risk factors of percutaneous subclavian vein catheters in pediatric patients enhancing the outcomes of a university hospital in a low income and middle income country |
| url | https://wjps.bmj.com/content/6/1/e000523.full |
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