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  

作　　者：Anouar Jarraya Manel Kammoun Ameni Chtourou Saloua Ammar Kamel Kolsi 

机构地区：[1]The Anesthesiology department,University of Sfax Faculty of Medicine of Sfax,Sfax,Tunisia [2]Department of Pediatric Surgery,Hedi Chaker Hospital,Sfax,Tunisia [3]University of Sfax Faculty of Medicine of Sfax,Sfax,Tunisia

出　　处：《World Journal of Pediatric Surgery》2023年第1期36-41,共6页世界小儿外科杂志（英文）

摘　　要：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 noncomplicated 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 ultrasoundguided approach,a multidisciplinary teaching program to improve nursing skills,and the use of less invasive devices for patients with cancer.

关 键 词：patients CATHETER PEDIATRIC 

分 类 号：R726[医药卫生—儿科]