iarms

IARMS

2709-3255

https://doi.org/10.47310/iarms.2021.v02i01.004

Central Venous Access in Lebanese Pediatric Population: Indications, Types, Policy of Insertion, Care and Complications

Fawzia

Medlej

Nada

Sbeity

Fatima

Yazbeck

BassemAbou

Merhi

Sirin

Mneimneh

AmaniSaleh Al

Rifai

Haidar

Houmani

Introduction: The use of Central Venous Catheters (CVC) is a common practice among ill pediatric patients with most common complication being catheter-related blood stream infections. Objectives: The primary objective is to study the CVC settings in Rafic Hariri University Hospital (RHUH) including assessment of the types of CVCs used, indications and determining the complications, especially infection. Secondary objectives are to assess the factors predisposing to infections, evaluate care guidelines applied in comparison to the international guidelines and come up with proposal of improvement plan. Subjects and Methods: This is a retrospective study, at RHUH. Charts reviewed of all patients <18 years admitted to the hospital from 1-1-2016 till 31-12-2017 and had CVC insertion. The data collected included the age of patients, CVC type and complications. Data was treated using SPSS version 22. Results: One hundred three pediatric patients were included. CVCs were mainly inserted for prolonged Intravenous (IV) therapy. The most prevalent type of CVC was Umbilical Venous Catheter (UVC). The most common complication was infection 68.75%. The predictors of CVC-related infection were increased age, longer CVC duration and chemotherapy. However, the only indication that persisted as an independent predictor of infection was chemotherapy 16 times higher risk). A statistically significant correlation was set at P-value less than 0.05. Conclusion: CVCs, mainly UVC, are mainly inserted in newborns due to prolonged IV therapy with infection as main complication. Residents, Neonatal Intensive Care Unit (NICU), prolonged insertion, malignancy and older age of the population proved significant effect on increasing risk of catheter related blood stream infections.