DEMOGRAPHICS AND OUTCOMES OF CENTRAL VENOUS CATHETER REPAIR IN A SINGLE PAEDIATRIC INTESTINAL FAILURE UNIT.

Griffiths, E.; Park, T.; Cernat, E.

DEMOGRAPHICS AND OUTCOMES OF CENTRAL VENOUS CATHETER REPAIR IN A SINGLE PAEDIATRIC INTESTINAL FAILURE UNIT.

All Authors

Griffiths, E.

Park, T.

Cernat, E.

LTHT Author

Griffiths, E.
Park, Tara
Cernat, Elena

LTHT Department

Leeds Children's Hospital
Paediatric Nutrition
Paediatric Gastroenterology

Non Medic

Dietitian

Publication Date

2025

Item Type

Conference Abstract

Abstract

For children with intestinal failure requiring parenteral nutrition (PN), their central venous catheter (CVC) is essential, to provide nutrition and fluid for growth, development, education and often life. These catheters are at risk of infection, thrombosis and damage and frequent line replacements can lead to loss of this life-preserving access.1 Current practice aims to preserve vascular access, of which part is repairing damaged CVCs in the first instance.1 The aim of this study is to describe the children requiring line repairs in a single paediatric intestinal failure unit and review the outcomes following line repair. All children registered with a single intestinal failure unit who underwent a CVC repair over a two-year period were identified (January 2021- December 2023). 9 children (7 male) underwent a total of 19 CVC repairs (range 1-5 repairs per patient). Intestinal failure was secondary to small bowel syndrome in 56%, the remainder dysmotility of varying causes. Median age at CVC repair was 6 years 1 month (interquartile range (IQR) 3 years 7 months to 7 years 9 months) 5 children had more than one CVC repair during the study period and 2 CVCs were repaired 3 times. At time of CVC repair 17 were on 7 nights PN with a median of 12hrs PN per night (range 11-24). The remaining child (2 CVC repairs) was on fluids only. At presentation the repaired line was the child's 5th line(median) (IQR 3-5) Median age of CVC at repair was 253 days (IQR 188.5- 377). The CVC had snapped in 5/19 cases, the remainder with visible fractures, holes, or loss of integrity. In 18 cases, the CVC was repaired by the on-call surgical registrar, the remainder by a haematology nurse practitioner. 5/19 (26%) CVC repairs were unsuccessful, requiring early (<7 days) replacement or further repair. Median CVC survival to further repair or replacement was 43 days (IQR 5-113) and from first repair to replacement 85.5 days (IQR 51.75-174). There were no central line associated blood stream infections (CLABSI)within 30 days of line repair, and only one CLABSI in a repaired line during the study period. (0.76 per 1000 catheter days). CVC repair is an effective and safe tool in prolonging a CVC lifespan, with a low infection rate in our cohort, similar or better than published literature.1-6 Early repair failure was relatively high in our cohort (26%) and may reflect varying levels of experience in the professionals performing the procedure. Intensive training is currently underway with a small cohort of staff with the aim of reducing the total number but increasing the experience and competence of staff undertaking CVC repair .