Risk factors for Hickman-Broviac catheter complications: An experience from a Tunisian hospital
DOI:
https://doi.org/10.47338/jns.v11.1120Keywords:
Hickman-Broviac catheter, Complications, Risk factors, Pediatrics, NeonatesAbstract
Background: Hickman-Broviac catheters have improved the care of young children needing frequent and prolonged venous access, but at the same times it has substantial morbidity, particularly in a resource-constrained setup. Our study aims to describe the experience of a Tunisian hospital and investigate the main risk factors for complications.
Methods: In this study, we included all the neonates and infants who underwent Broviac catheter insertion in the pediatric surgery department. The patients were divided into 2 groups according to the presence of complications. We compared these two groups and univariate logistic regression analyses were used to determine the risk factors for complications.
Results: Forty-three children were included in the study. The incidence of complicated catheters was 60.4%. The following factors were significantly associated with an increased risk of complications: age 6 months [OR 3.5, 95% CI: 0.6-19.3], weight 6 kg [OR 1.54, 95% CI: 0.46-5.2], emergency circumstances [OR 1.62, 95% CI: 0.8-5.4], and antibiotic-therapy as an indication for Broviac catheter insertion [OR 1.8, 95% CI: 0.5-6.2].
Conclusion: Complications seem to be more frequent in patients younger than 6 months and those with a weight of less than 6Kg. To reduce the morbidity related to the catheters, the indications should be carefully chosen.
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Thomas JH, MacArthur RI, Pierce GE, Hermreck AS. Hickman-Broviac catheters: Indications and results. Am J Surg. 1980; 140:791-6.
Pessa ME, Howard RJ. Complications of Hickman-Broviac catheters. Surg Gynecol Obstet. 1985; 161:257-60.
Perdikaris P, Petsios K, Vasilatou-Kosmidis H, Matziou V. Complications of Hickman-Broviac catheters in children with malignancies. Pediatr Hematol Oncol. 2008; 25:375-84.
Jarraya A, Triki Z, Guermazi J, Abdelkafi W, Galinski M, Karoui A. Femoral venous catheterization: a case of late femoral hematoma. Pan Afr Med J. 2014; 17:206.
Zhang JJ, Nataraja RM, Lynch A, Barnes R, Ferguson P, Pacilli M. Factors affecting mechanical complications of central venous access devices in children. Pediatr Surg Int. 2022; 38:1067-73.
Cesaro S, Corrò R, Pelosi A, Gamba P, Zadra N, Fusaro F, et al. A prospective survey on incidence and outcome of Broviac/Hickman catheter-related complications in pediatric patients affected by hematological and oncological diseases. Ann Hematol. 2004; 83:183-8.
Ammar S, Sellami S, Sellami I, Hamad AB, Hbaieb M, Jarraya A, et al. Risk factors of early mortality after neonatal surgery in Tunisia. J Pediatr Surg. 2020; 55:2233-7.
Ammar S, Sellami S, Sellami I, B. Hamad A, Jarraya A, Zouari M, et al. Management of esophageal atresia and early predictive factors of mortality and morbidity in a developing country. Dis Esophagus. 2019; 32:135.
Farou N, Lucas C, Olympia RP. School nurses on the front lines of healthcare: Children with medical devices—central venous access device malfunctions and infections. NASN School Nurse. 2021; 36:328-32.
Fritsch LM, Le M, Elrod J, Wössmann W, Vincent D, Reinshagen K, et al. Surgical experience affects the outcome of central venous access catheter implantation in children: A retrospective cohort study. J Pediatr Hematol Oncol. 2022; 8:10-97.
Moir D, Bodenham A. A narrative review of long-term central venous access devices for the intensivist. J Intensive Care Soc. 2018; 19:236-46.
Cesaro S, Cavaliere M, Pegoraro A, Gamba P, Zadra N, Tridello G. A comprehensive approach to the prevention of central venous catheter complications: results of 10-year prospective surveillance in pediatric hematology-oncology patients. Ann Hematol. 2016; 95:817-25.
Scott-Warren VL, Morley RB. Paediatric vascular access. BJA Educ. 2015; 15:199-206
Fratino G, Molinari AC, Parodi S, Longo S, Saracco P, Castagnola E, et al. Central venous catheter-related complications in children with oncological/hematological diseases: an observational study of 418 devices. Ann Oncol. 2005; 16:648-54.
Simon A, Graf N, Furtwängler R. Results of a multicentre survey evaluating clinical practice of port and Broviac management in paediatric oncology. Klinische Pädiatrie. 2013; 225:145-51.
Naik VM, Mantha SSP, Rayani BK. Vascular access in children. Indian J Anaesth. 2019; 63:737-45.
Blotte C, Styers J, Zhu H, Channabasappa N, Piper HG. A comparison of Broviac® and peripherally inserted central catheters in children with intestinal failure. J Pediatr Surg. 2017; 52:768-71.
Acosta CM, Tusman G. Ultrasound-guided brachiocephalic vein access in neonates and pediatric patients. Rev Esp Anestesiol Reanim (Engl Ed). 2021; 68:584-91.
Reddy SM, Soccorso G, Lawrence L, Bennett J, Jester I, Pachl M, et al. Ultrasound-guided percutaneous insertion of Broviac lines in infants less than 5kg: Prospective study of 100 consecutive procedures. . J Pediatr Surg. 2022; S0022-3468(22)00039-2.
Cotogni P, Mussa B, Degiorgis C, De Francesco A, Pittiruti M. Comparative complication rates of 854 central venous access devices for home parenteral nutrition in cancer patients: a prospective study of over 169,000 catheter‐days. JPEN J Parenter Enteral Nutr. 2021; 45:768-76.
Merchaoui Z, Laudouar Q, Marais C, Morin L, Ghali N, Charbel R, et al. Ultrasound guided percutaneous catheterization of the brachiocephalic vein by small caliber catheter: An alternative to epicutaneo-caval catheter in newborn and premature infants. J Vasc Access. 2021: 11297298211034311.
Alshafei A, Tareen F, Maphango N, White D, O'Connor B, Sriparan T. Open tunneled central line insertion in children—External or internal jugular vein?. J Pediatr Surg. 2018; 53:2318-21.
Fitzgerald RK, Jennifer CY, Rajasekaran S, Curtis SE, Robertson DJ, Wincek JM, et al. Cost and safety of pediatric intensive care physician-placed broviac catheters. Pediatr Crit Care Med. 2014; 15:71-6.
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Copyright (c) 2022 Manel Kammoun, Anouar Jarraya, Hend Ketata, Saloua Ammar, Mohamed Zouari, Chiraz Regaieg, Nadia Hentati, Mahdi Ben Dhaou, Riadh Mhiri
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