Elective removal of cuffed central venous catheters in children

Subcutaneously tunneled, cuffed central venous catheters (CVCs) are commonly used in children undergoing cytotoxic chemotherapy or hematopoietic stem-cell transplantation. When their use is no longer indicated or precluded by mechanical or infectious complications, CVCs have to be removed. General i...

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Bibliographic Details
Published in:Supportive care in cancer 2007-07, Vol.15 (7), p.897-901
Main Author: Lee, Anselm C W
Format: Article
Language:English
Subjects:
Catheterization, Central Venous
Catheters
Catheters, Indwelling
Child
Child Welfare
Databases as Topic
Device Removal - adverse effects
Drug Therapy
Embolism, Air - etiology
Embolism, Air - prevention & control
Hematopoietic Stem Cell Transplantation
Humans
Pediatrics
Risk Factors
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Summary:Subcutaneously tunneled, cuffed central venous catheters (CVCs) are commonly used in children undergoing cytotoxic chemotherapy or hematopoietic stem-cell transplantation. When their use is no longer indicated or precluded by mechanical or infectious complications, CVCs have to be removed. General instructions on how cuffed CVC should be removed are available in the medical texts but none is adapted for use in children. A literature search from the MEDLINE and EMBASE to identify articles describing the procedure of removing CVC or complications arising from the procedure was carried out. Specific guidance on the removal of CVC in children was not found. Venous air embolism appeared to be the most common complication associated with catheter removal but none involved pediatric patients. On the other hand, three out of the five incidents of catheter fracture with or without embolization happened in children. Further studies are needed to define the optimal management of CVC removal in pediatric patients. A sequence of positioning the child, use of sedation, dissecting out the cuff, pulling off the catheter, closing the exit wound, and handling of the removed catheter is suggested.
ISSN:0941-4355
1433-7339
DOI:10.1007/s00520-006-0182-y