Gülseren YILMAZ, NEVİN AYDIN, Osman ESEN, Naime YALÇIN, Özal ADIYEKE, ZİYA SALİHOĞLU, ABDURRAHİM DERBENT

Retrospective Analysis of Centrally Inserted Central Venous Catheters in Low Birth Weight Neonates: Our Experience with 50 Cases

INTRODUCTION: The use of centrally inserted central venous catheters (CICCs) allows maintenance of prolonged intravenous access in children. Our aim was to outline the characteristics of the low birth weight new-born population that received CICC and to present our therapeutic outcomes. METHODS: This retrospective study was performed using data derived from the medical files of 50 infants (37 females, 13 males) aged 81.3±55.3 days. Patients were treated in the neonatology department of our tertiary care centre. Relationship between demographic, clinical and hematologic variables was investigated. RESULTS: The vast majority of our patients had comorbidities (n=46, 92%). Complications were noted in 14 patients (28%) and revision was necessary in 9 (18%) cases. Catheter infection was evident in 18 patients (36%), while the tip of the catheter was most commonly detected at the levels of 5th (n=12, 24%) and 6th (n=9, 18%) costa. The reason for removal of the catheter was infection in only 15 (30%) of cases. The durability of CICC was significantly longer (p=0.027) and platelet count was notably higher (p=0.032) in patients that underwent revision intervention. In patients with infectious aetiology for removal of CICC, activated partial thromboplastin time was remarkably longer (p=0.045). DISCUSSION and CONCLUSION: We suggest that CICCs constitute a reliable, safe and practical route of access for prolonged intravenous treatment in infants with low birthweight. Identification of patients who may require revision intervention and increased awareness on catheter infection may improve success rate and decrease the likelihood of complications and hazards.

Düşük Doğum Ağırlıklı Yenidoğanlarda Santral Olarak Yerleştirilen Santral Venöz Kateterlerin Retrospektif Analizi: 50 Olgu ile Deneyimlerimiz

GİRİŞ ve AMAÇ: Santral ven kateterlerin (SVK) kullanımı, çocuklarda uzun süreli sıvı tedavi sağlanmasına izin verir. Amacımız, SVK yerleştirilen düşük doğum ağırlıklı yenidoğan bebeklerin klinik özellikleri ve tedavi sonuçlarını sunmaktır. YÖNTEM ve GEREÇLER: Bu retrospektif çalışma, düşük doğum ağırlıklı, ortalama yaşı 81.3 ± 55.3 gün olan 50 olgunun (37 kız, 13 erkek) tıbbi dosya ve bilgisayar kayıtlarından elde edilen veriler kullanılarak yapıldı. Olgular üçüncü basamak bakım merkezinin neonatoloji bölümünde tedavi edildi. Demografik, klinik ve hematolojik değişkenler arasındaki ilişki araştırıldı. BULGULAR: Olgular düşük doğum ağırlıklı olup büyük çoğunluğunda komorbidite vardı (n = 46,% 92). Komplikasyonlar 14 olguda (% 28) kaydedildi ve 9 (% 18) olguda revizyon gerekli oldu. Kateter enfeksiyonu 18 (% 36) olguda saptandı.Takılan kateter ucu en sık olarak 5. (n = 12,% 24) ve 6. (n = 9,% 18) kosta seviyesinde olduğu saptandı. Enfeksiyon 15 (% 30) olguda kateterin çıkarılma nedeniydi. SVK'in uzun süre kullanıldığı (p = 0.027) olgularda ve trombosit sayısı belirgin olarak yüksek (p = 0.032) olgularda revizyon uygulama oranı anlamlı derecede yüksekti. Enfeksiyon nedeniyle çıkartılması gereken SVK’lı olgularda aktive parsiyel tromboplastin süresi belirgin olarak uzundu (p = 0.045 ). TARTIŞMA ve SONUÇ: Düşük doğum ağırlıklı olgular genellikle komorbiditeye sahiptirler ve komplikasyonlara karşı hassastırlar. Bu olgulara uzun süreli sıvı tedavi gerekebilir ve SVK'ler ilaç uygulama ve parenteral nutrisyon için gerekli olabilir. Bu çalışmayla, SVK’ların düşük doğum ağırlıklı bebeklerde uzun süreli sıvı ve ilaç tedavi için güvenli ve pratik bir erişim yolu oluşturduğu bir kez daha gösterilmiştir.

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