Catheter-related complications in children with burns: A retrospective clinical study on 103 central venous access devices

INTRODUCTION: Central venous access devices (CVADs) are often indispensable for treating burns in children. Early and late complications related to CVAD placement may result in prolonged hospitalization, increased morbidity and mortality, and increased cost of care. METHODS: This retrospective, single-center, observational study describes catheter-related outcomes in children with burns who underwent CVAD insertion and were managed with standardized insertion and maintenance practices. The primary outcome was the incidence of catheter-related bloodstream infection (CRBSI), expressed per 1000 catheter days. RESULTS: A total of 103 CVADs in 81 patients admitted to our pediatric burn unit (mean age 5.1 years, mean TBSA 22.3%) were analyzed: 39 centrally inserted central catheters (CICCs), 47 femorally inserted central catheters (FICCs), and 17 peripherally inserted central catheters (PICCs). All CVADs were non-valved, non-cuffed, power-injectable polyurethane catheters; 84.5% were tunneled. The median dwell time was 18.3 days, for a total of 1883 catheter days. The incidence of CRBSI was 1.1 episodes per 1000 catheter days. Unscheduled removal due to catheter-related complications occurred in 11.7% of CVADs. No symptomatic catheter-related thrombosis was reported. CONCLUSIONS: In children undergoing CVAD placement as a part of burn care, catheter-related complications were infrequent in this cohort managed with a standardized insertion and maintenance approach. These descriptive findings could serve as a basis for future prospective studies.