Mechanical complications related to indwelling central venous catheter in pediatric hematology/oncology patients

Indwelling central venous catheters (CVC) are essential devices in the mana gement of children with oncologic/hematologic diseases or following bone na rrow transplantation. The authors report data on the mechanical complicatio ns observed in pediatric hematology/oncology patients, collected by a retro spective analysis of clinical records of 482 patients in whom 567 indwellin g central venous catheters had been inserted from January 1992 to December 1998 at rite G. Gaslini Institute. During the study period 52 episodes of m echanical complications (9%) were observed: mechanical obstruction (24 epis odes), catheter dislocation (13), problems related to catheter material (12 ), and accidental removal (3). In 25 cases removal and replacement of eve w as necessary for the treatment of complications, while medical treatment (t hrombolytic-antithrombotic) was successful and well tolerated in 8. The stu dy shows the importance of mechanical complications in children with indwel ling CVC for hematologic or oncologic diseases. Moreover; the experience of administering a systemic low-dosage thrombolytic therapy demonstrates new prospects of reducing CVC replacement by restoring CVC viability.