Document Detail

Mechanical complications during central venous cannulations in pediatric patients.
MedLine Citation:
PMID:  19529913     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: Identification of early mechanical complications (EMC) of central venous catheterizations (CVC) in pediatric patients and determination of EMC risk factors. DESIGN: Prospective observational study. SETTING: Pediatric intensive-care unit in a university hospital. PATIENTS AND MEASUREMENTS: Eight-hundred and twenty-five CVC were performed in 546 patients. Age, weight, gender, mechanical ventilation, analgesia, resident CVC failure, CVC indication, admission diagnosis, emergency or scheduled procedure, type of catheter (diameter, lumen number), catheter final location, number of attempts, and EMC were recorded. Risk factors for EMC were determined by multivariate analysis. RESULTS: Median patient age was 22.0 months (0-216 months). CVC was an emergency procedure in 421 (51%) cases, scheduled in 336 (40.7%), and guide-wire exchanged in 68 (8.2%). There were 293 (35.5%) internal jugular, 116 (14.1%) subclavian, and 416 (50.4%) femoral catheters. CVC was performed by staff physicians in 35.8% cases, supervised residents in 43.4%, and staff after resident failure in 20.8%. 151 EMC occurred in 144 CVC (17.5%). The most common EMC were arterial puncture (n = 60; 7.2%), catheter malposition (n = 39; 4.7%), arrhythmias (n = 19; 2.3%), and hematoma (n = 12; 1.4%). Resident failure to perform CVC (OR 2.53; CI 95% 1.53-4.16), high venous access (subclavian or jugular) (OR 1.91; CI 95% 1.26-2.88), and number of attempts (OR 1.10; CI 95% 1.03-1.17) were independently associated with EMC. CONCLUSIONS: EMC of CVC were common in a teaching university hospital, but severe complications were very uncommon. Resident failure to perform CVC, high venous access, and number of attempts were independent risk factors for EMC of CVC.
Corsino Rey; Francisco Alvarez; Victoria De La Rua; Alberto Medina; Andrés Concha; Juan José Díaz; Sergio Menéndez; Marta Los Arcos; Juan Mayordomo-Colunga
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Publication Detail:
Type:  Journal Article     Date:  2009-06-16
Journal Detail:
Title:  Intensive care medicine     Volume:  35     ISSN:  1432-1238     ISO Abbreviation:  Intensive Care Med     Publication Date:  2009 Aug 
Date Detail:
Created Date:  2009-07-20     Completed Date:  2009-11-09     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7704851     Medline TA:  Intensive Care Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1438-43     Citation Subset:  IM    
Paediatric Intensive Care Unit, Department of Paediatrics, Hospital Universitario Central de Asturias, University of Oviedo, Celestino Villamil s/n 33006, Asturias, Oviedo, Spain.
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MeSH Terms
Catheterization, Central Venous / adverse effects*
Child, Preschool
Hospitals, University
Infant, Newborn
Intensive Care Units, Pediatric*
Multivariate Analysis
Perioperative Care
Prospective Studies
Risk Factors

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