Complications associated with central venous lines for paediatric oncology patients at Universitas Academic Hospital, Bloemfontein, from 1992 to 2018

Abstract

Background. Central venous access devices are associated with complications such as central-line infections and systemic sepsis. Objective. To determine the complication rates associated with central venous lines used to administer chemotherapy at the Paediatric Haematology Oncology Unit, Universitas Academic Hospital, Bloemfontein, from January 1992 to March 2018. Methods. A retrospective descriptive analysis of paediatric oncology patients who received intravenous catheterisation and were treated at the unit. Cases with incomplete data, age >16 years and treatment after 31 March 2018 were excluded. Results. Records of 293 Hickman lines were analysed. The median patient age was 64.7 months. Sepsis was noted in 13.3% of the cases; no in situ local complications were found in 62.5% of the lines. Of the 39 cases that presented with line sepsis, 23.1% showed no signs of systemic sepsis, whereas 61.5% were neutropenic and septic. In total, 190 patients had symptoms of systemic sepsis and accompanying neutropenia. Of these, 67.4% did not develop in situ line complications. Lines were removed mostly because the end of treatment had been reached (44.7%); line sepsis was noted as the reason for removal in only 16.3% of cases. Conclusion. Despite the study population having a high risk for infections because of a young age, a large proportion of haematological malignancies and surgical placement of Hickman lines, there was a low incidence of line sepsis complications. The special care taken intraoperatively and meticulous aseptic postoperative handling and maintenance are suggested as contributing to limited infective complications.