The infected central line in children: Should it be removed?

Z. Steiner*, Y. Kandelis, J. Mogilner, S. Eldar, I. Srugo

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Central venous lines were placed in 47 children whose age ranged from 7 days to 16 years. All except one were of the Broviac type, and installed through a subcutaneous tunneling, via the internal or external jugular vein. The indications for central venous cannulations were chemotherapy, TPN, prolonged parenteral antibiotics, and repeated blood transfusions. In 13 patients (28%), 11 of which were immune compromised, infection originated from the catheter. The commonly identified bacteria were Staphylococcus aureus, Pseudomonas aeruginosa, Staphylococcus coagulose negative, and various gram negative rods. All cases were treated with antibiotics via the catheter. In 10 children, treatment was successful, omitting the need of removing the line. In two children, tunnel infection developed and hence, the catheter was extracted. One child accidently removed his catheter prior to initiation of treatment. No other complications were detected in the infected group treated conservatively except for one case who developed a superior vena cava thrombosis. In 7 out of 13, treatment was completed at home, saving 65 days of hospitalization. We conclude that in most instances of catheter related infection, a conservative approach should be considered and applied. However, in cases associated with tunnel infection, the catheter should instantly be removed. In selected cases, treatment can be carried out at home; this is cost effective and well accepted both by the children as well as by their families.

Original languageEnglish
Pages (from-to)11-14
Number of pages4
JournalPediatrik Cerrahi Dergisi
Volume11
Issue number1-2
StatePublished - 1997
Externally publishedYes

Keywords

  • Catheterization
  • Central venous
  • Infection

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