Replacement Versus Same-Site Salvage Using Hickman Catheter for Pediatric Stem Cell Transplantation Patients: A Comparative Study
| Autor: | Razan Bawazir, Osama A. Bawazir, Abdullah Bawazir, Soliman Binyahib |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Male
medicine.medical_specialty Catheterization Central Venous Adolescent Hickman line Vascular access 030204 cardiovascular system & hematology Risk Assessment 030218 nuclear medicine & medical imaging 03 medical and health sciences 0302 clinical medicine Hematoma Catheters Indwelling Risk Factors medicine Central Venous Catheters Humans Child Device Removal Retrospective Studies business.industry Infant General Medicine Odds ratio medicine.disease Surgery Transplantation Catheter Treatment Outcome Child Preschool Hickman catheter Female Stem cell Cardiology and Cardiovascular Medicine business Vascular Access Devices Stem Cell Transplantation |
| Zdroj: | Annals of vascular surgery. 76 |
| ISSN: | 1615-5947 |
| Popis: | Background Children undergoing bone marrow transplant need a double-lumen Hickman line. Therefore, changing Port-a-Cath ports to double-lumen Hickman catheter is mandatory. Several methods were described for changing Port-a-Cath ports either through the same-site or a new placement access site. The advantage of one method over the other is still debatable. We conducted this study to compare the safety and effectiveness of replacement versus salvage techniques to change ports to the Hickman lines before bone marrow transplants in pediatric patients. Methods We included 85 pediatric patients who underwent stem cell transplants. Their age ranged from 0.2 to 15 years. According to the Hickman reinsertion technique, we classified the patients into 2 groups; the Replacement group (n = 47) and the Same-site salvage group (n = 38). We compared the data before and after Hickman insertion between both groups. Study outcomes were the catheter duration, its complications, and mortality. Results The mean age of all patients was 4.7 ± 3.9 years, and 65.9% were males. There was no difference in the baseline data between both groups. During Port-a- Cath first insertion; 16.5% of patients suffered complications, with 10.6% had conversion to cut down, 1.2% had a hematoma, and 4.7% had multiple site insertion. We did not report differences between groups in the complications of the first port insertion. The Hickman duration was longer in the replacement group (4 (Q1-Q2: 2–6) vs. 1 (0.5–3) months, P = 0.005). Increased age (odds ratio [OR]: 1.31, P = 0.001) and male gender (OR: 1.19, P = 0.046) were independent predictors of mortality. Conclusions Endovascular same-site salvage technique could help preserve vascular access during the tunnel catheter exchange for noninfectious reasons. We recommend the use of the same-site salvage technique in pediatric transplant patients. |
| Databáze: | OpenAIRE |
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