Short-term complications of central line placement in children with the human immunodeficiency virus

Purpose: The aim of this study was to characterize the perioperative compli cations of central venous catheter placement in children infected with huma n immunodeficiency virus (HIV). Methods: A retrospective chart review was conducted of all central venous c atheters placed by the surgical service into HIV-infected children from 198 8 to 1998 at a large urban children's hospital, Complications occurring wit hin 1 month of catheter placement were analyzed for several host and enviro nmental factors. Results: Forty HIV-positive patients underwent 60 central venous access pro cedures. Thirty-two of the patients were severely immunosuppressed. Eight c atheter placements (13%) resulted in perioperative complications, including hemorrhage (n = 2), site infection (n = 2), catheter sepsis (n = 2), throm botic occlusion (n = 1), and a pleural effusion secondary to catheter malpo sition (n = 1). Only 3 patients required catheter removal. There was no sig nificant relation-ship between either hemophilia or thrombocytopenia and pe rioperative hemorrhage. No significant relationship was found between infec tious complications and preoperative white blood cell count, absolute neutr ophil count, CD4% and CD4#, suggesting that a patient's compromised immune status should not be considered a contraindication to central venous cathet er placement. Conclusion. The complication rate of central venous catheter placement into HIV-infected children is low (< 15%), but is still higher than that of the general pediatric population. With careful preoperative preparation this p rocedure can be performed safely, even in patients with advanced HIV diseas e. Copyright (C) 2001 by WB, Saunders Company.