Implantable versus cuffed external central venous catheters for the management of children and adolescents with acute ly
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ORIGINAL ARTICLE
Implantable versus cuffed external central venous catheters for the management of children and adolescents with acute lymphoblastic leukaemia Alan D. White • Diaa Othman • Michael J. Dawrant Soroush Sohrabi • Alastair L. Young • Roly Squire
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Accepted: 24 October 2012 / Published online: 23 November 2012 Ó Springer-Verlag Berlin Heidelberg 2012
Abstract Purpose The aim of this study was to determine if there is a difference between complications for totally implantable central venous catheters (ports) and tunnelled external central venous catheters (external CVCs) that result in early removal of the central venous catheter (CVC) in children and adolescents with acute lymphoblastic leukaemia (ALL). Methods All children hospitalised between November 1996 and December 2007 with ALL who had a CVC were included retrospectively. We analysed data regarding the patient’s first CVC. Results We included 322 patients. 254 received a port and 68 received an external CVC. There were 102 CVC complications that required removal of the CVC prior to the completion of chemotherapy (65 in patients with ports, 37 in patients with external CVCs). Overall complications requiring CVC removal were significantly less likely to occur in the patient’s with ports (p \ 0.001). Ports were significantly less likely to require removal prior to the end of treatment overall (p \ 0.001) and for specific complications such as infection (p \ 0.001) and dislodgement
A. D. White D. Othman M. J. Dawrant R. Squire Paediatric Surgical Department, Leeds Children’s Hospital, Leeds, UK A. D. White (&) A. L. Young Hepatobiliary and Transplant Unit, St James’s University Hospital, Beckett Street, Leeds LS9 7TF, UK e-mail: [email protected] S. Sohrabi Leeds Institute of Genetic Health and Therapeutics, University of Leeds, Leeds, UK
(p = 0.001). However, when adjusted for disease severity there is no difference in premature CVC removal rates. Conclusion When patients are risk-stratified for disease severity there is no difference in rates of CVC removal prior to completion of treatment. Keywords Oncology General ALL Outcomes research
Introduction The use of central venous access is integral in the management of acute lymphoblastic leukaemia (ALL). There are two main types of central venous catheter (CVC): totally implantable venous access devices (ports) and tunnelled external central venous catheters (external CVCs). Evidence suggests that implanted CVCs are easier to care for and have higher levels of patient preference compared to external CVCs [1, 2]. Reported complication rates in children are between 10 and 26 % for implantable devices and 9–46 % for external CVCs [2–7]. The aim of this study was to determine if there is a difference between complication rates for implantable venous access devices and cuffed external catheters which result in early removal of the CVC in children and adolescents with ALL.
Methods This study was conducted at a single Children’s Cancer Centre using data from a prospectively maintain
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