TY - JOUR
T1 - Central venous catheter-associated complications in pediatric patients diagnosed with Hodgkin lymphoma
T2 - implications for catheter choice
AU - van den Bosch, Ceder
AU - Spijkerman, Judith
AU - Wijnen, Marc
AU - Kremer Hovinga, Idske
AU - Meyer - Wentrup, Friederike
AU - van der Steeg, Alida F W
AU - van de Wetering, Marianne
AU - Fiocco, Marta
AU - Morsing, Indra
AU - Beishuizen, Auke
N1 - Funding Information:
We would like to acknowledge all patients and parents who gave permission to the use of their clinical data for research. Furthermore, we would like to acknowledge the Princess Máxima Center for Pediatric Oncology for the support of this research.
Publisher Copyright:
© 2022, The Author(s).
PY - 2022/10
Y1 - 2022/10
N2 - PURPOSE: The purpose of this study was to determine the most optimal central venous catheter (CVC) for pediatric patients with Hodgkin lymphoma (HL) in terms of complications.METHODS: A retrospective study including patients diagnosed with HL from 2015 to 2021 at the Princess Máxima Center was performed. Patients were followed from CVC insertion until removal or 06-2021, whichever came first. The primary outcome was the CVC-related complication incidence rate (IR) per 1000 CVC-days. Furthermore, the incidence rate ratio (IRR) was calculated by comparing complication IRs between peripherally inserted central catheters (PICC) and totally implantable venous access ports (TIVAP). Additionally, risk factors for central venous thrombosis (CVT) were identified.RESULTS: A total of 98 patients were included. The most frequently observed complications were local irritation/infections (18%; IR 0.93), malfunctions (15%; IR 0.88), and CVC-related CVTs (10%; IR 0.52). Single lumen PICCs were associated with a higher risk of complications (49% vs. 26%; IRR 5.12, CI95% 2.76-9.50), severe complications (19% vs. 7%; IRR 11.96, CI95% 2.68-53.42), and early removal (18% vs. 7%; IRR 9.96, CI95% 2.18-45.47). A single lumen PICC was identified as a risk factor for CVC-related CVT when compared to TIVAPs (12% vs. 7%, IRR 6.98, CI95% 1.45-33.57).CONCLUSION: The insertion of a TIVAP rather than a PICC should be recommended for pediatric patients with HL, especially in the presence of CVT-related risk factors. Future trials should evaluate the efficacy and safety of direct oral anticoagulants for the primary prevention of CVT in pediatric patients with a PICC and other CVT-related risk factors.
AB - PURPOSE: The purpose of this study was to determine the most optimal central venous catheter (CVC) for pediatric patients with Hodgkin lymphoma (HL) in terms of complications.METHODS: A retrospective study including patients diagnosed with HL from 2015 to 2021 at the Princess Máxima Center was performed. Patients were followed from CVC insertion until removal or 06-2021, whichever came first. The primary outcome was the CVC-related complication incidence rate (IR) per 1000 CVC-days. Furthermore, the incidence rate ratio (IRR) was calculated by comparing complication IRs between peripherally inserted central catheters (PICC) and totally implantable venous access ports (TIVAP). Additionally, risk factors for central venous thrombosis (CVT) were identified.RESULTS: A total of 98 patients were included. The most frequently observed complications were local irritation/infections (18%; IR 0.93), malfunctions (15%; IR 0.88), and CVC-related CVTs (10%; IR 0.52). Single lumen PICCs were associated with a higher risk of complications (49% vs. 26%; IRR 5.12, CI95% 2.76-9.50), severe complications (19% vs. 7%; IRR 11.96, CI95% 2.68-53.42), and early removal (18% vs. 7%; IRR 9.96, CI95% 2.18-45.47). A single lumen PICC was identified as a risk factor for CVC-related CVT when compared to TIVAPs (12% vs. 7%, IRR 6.98, CI95% 1.45-33.57).CONCLUSION: The insertion of a TIVAP rather than a PICC should be recommended for pediatric patients with HL, especially in the presence of CVT-related risk factors. Future trials should evaluate the efficacy and safety of direct oral anticoagulants for the primary prevention of CVT in pediatric patients with a PICC and other CVT-related risk factors.
KW - Central venous catheter
KW - Complications
KW - Hodgkin lymphoma
KW - Pediatric
KW - Thrombosis
UR - https://pubmed.ncbi.nlm.nih.gov/35776186/
UR - http://www.scopus.com/inward/record.url?scp=85133249218&partnerID=8YFLogxK
UR - https://www.mendeley.com/catalogue/a7d37885-dc82-364e-80f1-ff1f6f5064fa/
U2 - 10.1007/s00520-022-07256-3
DO - 10.1007/s00520-022-07256-3
M3 - Article
C2 - 35776186
SN - 1433-7339
VL - 30
SP - 8069
EP - 8079
JO - Supportive Care in Cancer
JF - Supportive Care in Cancer
IS - 10
ER -