The following is a summary of “Causes and Outcome of Central Venous Catheter Repair in Children with Intestinal Failure on Home Parenteral Nutrition,” published in the December 2023 issue of Pediatrics by Zaidi, et al.

For a study, researchers sought to investigate the causes and outcomes associated with repairing central venous catheters (CVC) in children dependent on home parenteral nutrition (PN). Recognizing the risks associated with CVC breakage in this population, the focus was on assessing the efficacy and safety of repairing these catheters instead of removing them.

The study involved children aged between 0 and 17 years dependent on CVCs for home parenteral nutrition and enrolled in the Intestinal Failure (IF) rehabilitation program at a pediatric referral center. The research specifically examined those who underwent a CVC repair between January 2019 and November 2020. Retrospective data collection included identifying causes of CVC breakage and monitoring the occurrence of central line-associated bloodstream infections (CLABSIs) subsequent to the repair. Descriptive statistics, such as medians, percentages, and frequencies, were employed to analyze the collected data.

Out of the identified cohort of 40 children, comprising 15 males (37%) and 25 females (63%), 15 patients (37.5%) underwent a total of 29 CVC repairs. This translated to a repair rate of 0.1 repairs per 1,000 catheter days. Among these, 8 out of 15 patients (53%) were below the age of 5 years, with a higher representation of females at 33%. The predominant cause necessitating repair was CVC fracture due to biting, accounting for 41% of cases, followed by catheter occlusion attributed to intraluminal PN deposition at 13.2%. Remarkably, the repair procedure proved successful in all cases. Post-repair, only one patient (3% of repairs) experienced a confirmed CLABSI, presenting 3 days subsequent to the initial catheter breakage. Fortunately, this catheter-associated bloodstream infection was successfully managed using antibiotics.

The findings underscored the high success rate of CVC repairs in the studied pediatric cohort, with a minimal incidence of infections post-repair. Based on the outcomes, the study advocated for the repair rather than the removal of CVCs in children reliant on home parenteral nutrition, emphasizing the importance of preserving central venous access.

Source: journals.lww.com/jpgn/abstract/2023/12000/causes_and_outcome_of_central_venous_catheter.22.aspx