Abstract
Purpose
The number of accessible central veins (CVs) affects the prognosis of patients with intestinal failure (IF). The loss of residual CVs should be avoided. We, therefore, evaluated the efficacy of a new CV catheter-exchange technique using a subcutaneous fibrous sheath (FS) in pediatric IF patients.
Methods
We retrospectively collected the CV catheter (CVC) data of pediatric IF patients managed from January 2009 to December 2019. The data were divided into two groups; Groups 1 (CVCs placed with the FS method) and Group 2 (CVCs placed by the primary or another insertion). The main outcome was the CVC indwelling time.
Results
Eighty-five CVCs were analyzed. The FS method was attempted in 47 cases and succeeded in 40 (85%). No significant difference was observed between the groups regarding characteristics. A log-rank test revealed an equivalent CVC indwelling time between the two groups (Group 1: 268 [126–588] days vs. Group 2: 229 [126–387] days, p = 0.256).
Conclusions
The FS method is highly recommended for pediatric IF patients, as its attempt showed a high success rate with an indwelling time equivalent to primary insertion. The FS method leads to the prolonged use of a single CV and thereby contributes to improving the outcomes of pediatric IF patients.
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Code availability
The datasets in this study are available from the corresponding author upon reasonable request.
Abbreviations
- IF:
-
Intestinal failure
- FS:
-
Fibrous sheath
- CV:
-
Central vein
- CVC:
-
Central venous catheter
- CLABSI:
-
Central line-associated bloodstream infection
- SBS:
-
Short bowel syndrome
- HD:
-
Hirschsprung’s disease
- ADHD:
-
Allied disorders of Hirschsprung’s disease
- CIIP:
-
Chronic idiopathic intestinal pseudo-obstruction
- TPN:
-
Total parenteral nutrition
- MVID:
-
Microvillus inclusion disease
- IT:
-
Intestinal transplantation
- IQR:
-
Inter-quartile range
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Acknowledgements
We thank Brian Quinn for the English language editing.
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KN: designed the study and, TK: analyzed the data, and wrote the draft of the manuscript. TJ, JK, NK, SO, KY, KM, GE, TM: contributed to the data collection, data cleaning, interpretation. KN, KM, TT, and TT: critically reviewed this manuscript. The final version of the manuscript was approved by all authors.
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The authors have no conflicts of interest to disclose.
Ethical approval
This study was approved by the ethics committee of Kyushu University (Ethical approval number 30-338).
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Kondo, T., Nagata, K., Jimbo, T. et al. “A salvage technique using a fibrous sheath to avoid the loss of the central veins in cases of pediatric intestinal failure”. Pediatr Surg Int 38, 1855–1860 (2022). https://doi.org/10.1007/s00383-022-05233-9
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DOI: https://doi.org/10.1007/s00383-022-05233-9