Long-term use of indwelling multipurpose silastic catheters in pediatric cancer patients treated with aggressive chemotherapy.
Long-term use of indwelling multipurpose silastic catheters in pediatric cancer patients treated with aggressive chemotherapy.
复制标题
在接受积极化疗的儿科癌症患者中长期使用留置多用途硅胶导管。
DOI：
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发表时间：
1986
影响因子：
45.3
通讯作者：
F. Hodder
中科院分区：
文献类型：
--
作者：
M. Cairo;S. Spooner;L. Sowden;G. Bennetts;B. Towne;F. Hodder
We studied the complications related to the use of 53 multipurpose silastic catheters (MSC) placed in 46 pediatric cancer patients over a 1-year period. We documented the longest duration of catheter placement in the pediatric oncology literature. There were 7,650 Broviac days (range, 9 to 365 days; mean, 163 days) with 255 patient months of catheter use and a mean of 5.5 months per catheter. Of the 53 MSCs, 90% were Broviacs (72% adult size, 18% pediatric size) and 10% Hickman. There were 23 episodes of bacteremias or 0.31 episodes per 100 days of catheter use. Coagulase-negative staphylococci were isolated in 20% of the episodes of bacteremia. Only 34% had an absolute granulocyte count (AGC) (Polymorphonuclear cells [PMN] + band cells) less than 500 in the 23 MSCs with bacteremia. Ten percent were removed: 4% for mechanical problems, 6% for bacteremia unresponsive to appropriate antibiotic therapy. There were no deaths related to bacteremia, embolism, or vascular damage. This study demonstrated that despite the recent use of more aggressive immunosuppressive therapy, the incidence of MSC bacteremias was 43%, similar to earlier National Cancer Institute studies (39%) American Society of Clinical Oncology, (abstract C-219, 1982). Based on these findings, we have currently modified our MSC care and have recently throughout the past 6 months reduced our infectious complication rate by 50%.
