Central venous catheter complications in sickle cell disease

Abstract

A review of patients with sickle cell disease (SCD) and central venous catheters (CVCs) was performed to evaluate the frequency of catheter complications (infections, thrombotic events, and premature CVC removal. Fifteen evaluable patients were identi®ed during our review of a 7.5-year period. The median age was 18 years (range, 1.5±30 years); 14 were African American, and 1 was Latino; 5 were male, and 10 were female. Forty-one CVCs were placed (36 Mediport and 5 Broviac catheters) for a total of 12,120 CVC days. We observed a median of 2 CVCs per patient (range, 1±8 CVCs per patient) with 67 discrete episodes of CVC-associated infection (range, 0±18 per patient) involving 10 patients. The rate of CVC-associated infection for patients with SCD at our institution was 5.5 infections per 1,000 CVC days; this rate was signi®cantly higher than the rate of CVC-associated infection in our patients with cancer (P < 0.001). We also determined that the rate of CVC-associated thrombosis was 0.99 events per 1,000 CVC days and involved 33% of the patients with SCD; the rate of premature CVC removal was 3.15 per 1,000 CVC days, and 78% of CVCs were removed prematurely. We conclude that patients with SCD are at high risk for CVC-related complications, and improved care and close monitoring of CVCs should be encouraged to decrease morbidity in these chronically ill patients.

Prevalence and risk factors for venous thromboembolism in children with sickle cell disease: an administrative database study

“…6,35,36 The first attempt to systematically study VTE in pediatric patients with SCD was made by Tiago de Oliveira Boechat and colleagues in 2015. 37 They performed a retrospective study of 1063 patients followed at the State Institute of Hematology of Rio de Janeiro between the years 2000-2012.…”

Guidelines on red cell transfusion in sickle cell disease. Part I: principles and laboratory aspects

“…Indwelling central venous catheters have a high complication rate, particularly infection, among SCD patients compared with other patient groups (McCready et al, 1996;Jeng et al, 2002;Wagner et al, 2004;Alkindi et al, 2012;Shah et al, 2012). Lower complication rates have been reported in one small study in children (Bartram et al, 2011) and in another study where a particular implantable device was used (Raj et al, 2005).…”

Complications of PORT-A-CATH® in patients with sickle cell disease

“…This increased risk is due to higher incidence of infection, thrombosis, mechanical occlusions, and other complications [6][7][8][9][10]. SCD patients are inherently immunocompromised and are at risk of infections caused by splenic dysfunction, medication, or repeated hospital admissions with exposure to potent antibiotics and nosocomial pathogens.…”