肿瘤医学与实践杂志

Central Line Associated Thrombosis in Pediatric Oncology Patients: Single Center Experience

Abstract

Fatimah Almoaraj*, Hala Omer, Esraa AlQasem, Badriah Alomari, Ashraf Khairy, Qasim Alharbi, Omar Chamdine, Saad ALdaama, and Maher El Doussouki

Background: Central venous lines are important part in management of pediatric oncology patients, in spite of that, obtaining these access carry risk of complication. Central Venous Catheter-related Thrombosis (CVCT) is one of the major complications.

Methods: This is a single-center retrospective study; we analyzed all pediatric oncology patients with a Central Venous Catheter (CVC) over 3 years period, focused on the CVCT risk factor and its outcome. Data were retrieved from patients’ hard and electronic medical records and collected in the Redcap system.

Results: A total of 323 CVCs were inserted in 266 pediatric oncology patients, 14 CVCT episodes were discover (4.33%) which was occurred in 13 patients. The incidence of CVCT was highest among hematological malignancy 10 out of 13 patients. Using steroid as part of chemotherapy was recognized as significant risk for CVCT (P value: 0.019), having a peripherally inserted central catheter PICC or femoral line compared with an implantable port Cath were associated with increased risk of CVCT (P value <.001) besides of that the risk of thrombosis increased with subsequent insertions of the central line compared with a single central line insertion (P value: .004). 50% of CVCT were asymptomatic, LMWH was used in 9 episodes and line removed in 7, complete resolution occurred in 10 episodes.

Conclusion: The use of CVC is a crucial corner in managing pediatric oncology patients and improves their quality of life, yet it is associated with significant complications, such as infection, thrombosis, and dysfunction.

The pediatric oncologists and pediatric surgeons should pay special attention to ensure optimal and appropriate CVC placement methods and post-insertion care which may play an essential role in minimizing CVC-associated complications.

Prospective studies are crucial to evaluate the clinical significance of CVC-dysfunction and its impact on the development of thrombosis, infection, or outcome of children with cancer. And to provide recommendations to improve the preventive strategies for such events.