Derya Alabaz, R. Dinçer Yıldızdaş, Hüseyin Elçi, İlknur Tolunay

Assessment of central venous catheterization and complications in a tertiary pediatric intensive care unit

In catheter-using units as pediatric intensive care, it is important to know thecomplications that may occur during the insertion and use of central venouscatheterization (CVC), and to take appropriate measures in order to reducethe mortality and morbidity of critical patients. The aim of this study wasto evaluate CVC and catheter related complications in our tertiary pediatricintensive care unit. For this prospective study, 155 central venous cathetersand/or hemodialysis catheters used with 106 patients, between August 2014and August 2015 were evaluated. Demographic information about patients,catheter insertion procedure and catheter related complications were recorded.Sixty-two (58.5%) male and forty-four (41.5%) female patients were evaluatedin this study. The median age was 67.5 months (1-212). The mean dwelltime of catheters was 10.54±8 days. Twenty-two (14.2%) catheters wereremoved from patients because of catheter related complications. The meandwell time of complicated catheters was 10.6±8.5 days and there was nostatistically significant difference between complicated and non-complicatedcatheters. Catheter related blood stream infections was diagnosed in 5.1%(8/155) patients and these catheters were removed from patients. Includingthese patients, positive blood culture was found to be at 14.2% (22/155). Themean dwell time of catheters with positive blood culture was 14.25±7.3 days.The mean dwell time of catheters with positive blood culture was statisticallysignificantly longer than catheters with negative blood culture. In the 3 patientswho developed catheter thrombosis, 2 patients were followed up because ofinfection/sepsis and 1 patient had a neurological disease. Catheter thrombosisdeveloped in 1 femoral vein and 2 internal jugular veins. The developmentof central venous catheter complications depends on many different factorsand it is possible to reduce the complications with precautions taken duringreplacement and daily use.

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