Single- vs double-lumen central venous catheters in pediatric oncology patients
R. J. Shulman, E. O. Smith, S. Rahman, P. Gardner, T. Reed and D. Mahoney
Texas Children's Hospital, Houston.
Double-lumen central venous catheters (CVCs) have been introduced recently
for use in pediatric patients. The objective of our study was to determine
if double-lumen CVC usage increased the possibility of infectious and
mechanical complications compared with that of traditional single-lumen
CVCs in a population at high risk for infection (oncology patients). Thirty
pediatric patients (2.5 +/- 3.0 years old; mean +/- SD) who received
single-lumen CVCs were compared with 31 patients (5.9 +/- 4.7 years old)
who received double-lumen CVCs. The incidence of infectious complications
was compared while controlling for potential confounding variables.
Fifty-seven percent (17/30) of patients in the single-lumen group
experienced bacteremia or cellulitis that required removal of six catheters
compared with a rate of 52% (16/31) and nine catheter removals in the
double-lumen group. Fewer manipulations occurred in the single-lumen group
compared with the double-lumen group, but the incidence of mechanical
complications tended to be greater. When managed carefully, double-lumen
CVCs were not associated with a greater risk of infection than single-lumen
CVCs.
