Journal of Medical and Surgical Intensive Care Medicine 2016 , Vol 7, Issue 1
Evaluation of Central Venous Catheterization Complications and Related Risk Factors in a Pediatric Intensive Care Unit
Ayşe Betül Ergül 1 , Alper Özcan 1 , Hümeyra Aslaner 2 , Seçil Köse 2 , Hacı Ahmet Aslaner 3 , Ramazan Coşkun 4 , Yasemin Altuner Torun 5
1Kayseri Eğitim ve Araştırma Hastanesi, Çocuk Yoğun Bakım Ünitesi, Kayseri, Türkiye
2Kayseri Eğitim ve Araştırma Hastanesi, Pediatri Kliniği, Kayseri, Türkiye
3Erciyes Üniversitesi Tıp Fakültesi, Dahiliye Anabilim Dalı, Kayseri, Türkiye
4Erciyes Üniversitesi Tıp Fakültesi, Dahiliye Yoğun Bakım Ünitesi, Kayseri, Türkiye
5Kayseri Eğitim ve Araştırma Hastanesi, Çocuk Hematoloji Bölümü, Kayseri, Türkiye
DOI : 10.5152/dcbybd.2016.818

Objective: In this study, we aimed to evaluate central venous catheter insertion related complications and related risk factors in a pediatric intensive care unit.

Material and Methods: All patients hospitalized between 17.10.2012 and 24.08.2014 in a pediatric intensive care unit were included in the study. Central venous catheterization patients in terms of age, sex, cause of catheter insertion, and removal, depending on catheter interventions, were evaluated in terms of developing complications and risk factors.

Results: A total of 139 catheter insertions were performed. The success rate of catheterization was 95%, attempt complication rate was 21.6%, and catheter-related blood stream infections occurred for 16.2 catheter days per 1000 catheterization days. The median duration of the catheters in place was 14 days (1–68) days. The most common site of intervention was the femoral region (38.8%), followed by subclavian (30.9%) and jugular regions. The most common complication of attemps was arterial puncture (12.2%), followed by malposition (4.3%), pneumothorax (3.5%) and other complications (2.1%).  Serious complications were most common in subclavian insertions (p<0.05). After insertion, the most common complication during follow-up was catheter-associated bloodstream infection. There were no significant differences between the regions in terms of catheter-associated bloodstream infections (p>0.05). The risk of infection increased with increased duration of hospitalization (p>0.05).

Conclusion: Despite associated complications, central venous catheter placement is a safe procedure in children. We suggest preference of  the femoral or internal jugular vein initially,  instead of the subclavian vein, because of  fewer serious insertion-related complications. 

Keywords : Children, complication, central venous catheterization, critical care