Background: Reliable central venous access (CVC) is essential for hematologyââ?¬â??oncology patients since frequent\npuncture of peripheral veinsââ?¬â?e.g., for chemotherapy, antibiotic administration, repeated blood sampling, and\nmonitoringââ?¬â?can cause unacceptable pain and psychological trauma, as well as severe side effects in cases of\nextravasation of chemotherapy drugs. However, CVC lines still carry major risk factors, including thrombosis,\ninfection (e.g., entry site, tunnel, and luminal infections), and catheter dislocation, leakage, or breakage.\nMethods: Here we performed a retrospective database analysis to determine the incidence of CVC-associated\nthrombosis in a single-center cohort of 448 pediatric oncologic patients, and to analyze whether any subgroup of\npatients was at increased risk and thus might benefit from prophylactic anticoagulation.\nResults: Of the 448 patients, 269 consecutive patients received a CVC, and 55 of these 269 patients (20%) also had\na thrombosis. Of these 55 patients, 43 had at least one CVC-associated thrombosis (total number of CVC-associated\nthrombosis: n = 52). Among all patients, the median duration of CVC exposure was 464 days. Regarding exposure\ntime, no significant difference was found between patients with and without CVC-associated thrombosis. Subclavia\ncatheters and advanced tumor stages seem to be the main risk factors for the development of CVC-associated\nthrombosis, whereas pharmacologic prophylaxis did not seem to have a relevant impact on the rate of thrombosis.\nConclusions: We conclude that pediatric surgeons and oncologists should pay close attention to ensuring optimal\nand accurate CVC placement, as this appears the most effective tool to minimize CVC-associated complications.
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