Venous access devices have been in use since 1973 and have made a tremendous impact on care of children with malignancies to facilitate the delivery of complex medical care and minimize the trauma associated with cancer therapy. During the past 20 years the variety and complexity of available devices has resulted in an increased demand for technical knowledge and expertise to prevent complications and assure safe use. This article reviews the various devices, complications and implications for nursing practice, and recommendations for pediatric nursing regarding patient/parent self-care and developmental safety issues.
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References
1.
Hickman R., Buckner C., Clift R., et al: A modified right atrial catheter for access to the venous system in marrow transplant recipients. Surg Gynecol Obstet148:871-875, 1979
2.
Curtas S., Bonaventura M., Mëguid M.: Cannulation of inferior vena cava for central venous access. Surg Gynecol Obstet168:121-124, 1989
3.
Slater H., Goldfarb I., Jacob H., et al: Experience with long-term outpatient venous access utilizing percutaneously placed silicone elastomer catheters. Cancer56:2074-2077, 1985
4.
Broadwater J. , Henderson M., Bell J., et al: Outpatient percutaneous central venous access in cancer patients. Am J Surg160:676-679, 1990
5.
Bonventre V. , Lally K., Chwals W., et al: Percutaneous insertion of subclavian venous catheters in infants and children. Surg Gynecol Obstet169:203-205, 1989
6.
Hayward S., Hedgewood A., Lucas C.: The fate of 100 prolonged venous access devices. Am Surg56(9):515-519, 1990
7.
Ross M., Haase G., Poole M., et al: Comparison of totally implanted reservoirs with external catheters as venous access devices in pediatric oncologic patients. Surg Gynecol Obstet167:141-144, 1988
8.
Mirro J., Rao B., Stokes D., et al: A prospective study of Hickman/Broviac catheters and implantable ports in pediatric oncology patients. J Clin Oncol7:214-222, 1989
9.
Wurzel C., Halom K., Feldman G., et al: Infectious rates of Broviac-Hickman catheters and implantable venous devices. Am J Dis Child142:536-540, 1988
10.
Masoorli S. , Angeles T.: PICC lines—the latest home care challenge . RN1:44-51, 1990
11.
Hathorn JW, Pizzo PA: Infectious complications in the pediatric cancer patient, in Pizzo PA, Poplack DG (eds): Principles and Practice of Pediatric Oncology. Philadelphia, PA, Lippincott, 1989 , pp 837-869
12.
Shulman R., Smith E., Rahman S., et al: Single- vs double-lumen central venous catheters in pediatric oncology patients. Am J Dis Child142:893-895, 1988
13.
Hartman G., Shochat S.: Management of septic complications associated with Silastic catheters in childhood malignancy. Pediatr Infect Dis J6:1042-1047, 1987
14.
Becton D., Kletzel M., Galladay E., et al: An experience with an implanted port system in 66 children with cancer. Cancer61:376-378, 1988
15.
Johnson P., Decker M., Edwards K., et al: Frequency of Broviac catheter infections in pediatric oncology patients. J Infect Dis154:570-578, 1986
16.
Flynn P., Shenep J., Stokes D., et al: In situ management of confirmed central venous catheter-related bacteremia. Pediatr Infect Dis J6:729-734, 1987
17.
Nahata M., King D., Powell D., et al: Management of catheter-related infections in pediatric patients . JPEN J Parenter Enteral Nutr12:58-59, 1988
18.
Shivnan J., McGuire D., Freedman S., et al: A comparison of transparent adherent and dry sterile gauze dressings for long-term central catheters undergoing bone marrow transplantOncol Nurs Forum18(8):1349-1356, 1991
19.
Petrosino B. , Becker H., Christian B.: Infection rates in central venous catheter dressings. Oncol Nurs Forum15(6):709-716, 1988
20.
Bagnall-Reeb HA, Ruccione K.: Management of cutaneous reactions and mechanical complications of central venous access devices in pediatric patients with cancer: Algorithm for decision making. Oncol Nurs Forum17:677-681, 1990
21.
Armstrong C. , Mayhall G., Miller K., et al: Clinical predictors of infection of central venous catheters used for total parenteral nutrition. Infect Control Hosp Epidemiol11:71-78, 1990
22.
Decker M., Edwards K.: Central venous catheter infections. Pediatr Clin North Am35(3):579-612, 1988
23.
Shulman R., Reed T., Pitre D., et al: Use of hydrochloric acid to clear obstructed central venous catheters. JPEN J Parenter Enteral Nutr12:509-510, 1988
24.
Smith S., Dawson S. Hennessey R, et al: Maintenance of the patency of indwelling central venous catheters: Is heparin necessary?Am J Pediatr Hematol Oncol13(2):141-143, 1991
25.
Brown LH, Wantroba I., Simonson G.: Reestablishing patency in an occluded central venous access device. Crit Care Nurs9:114-121, 1989
26.
Atkinson J., Bagnall H., Gomperts E.: Investigational use of tissue plasminogen activator (t-PA) for occluded central venous catheters. JPEN J Parenter Enteral Nutr14:310-311, 1990
27.
Bagnall H., Gomperts E., Atkinson J.: Continuous infusion of low-dose urokinase in the treatment of central venous catheter thrombosis in infants and children. Pediatrics83:963-966, 1989
28.
Haire W., Lieberman R., Lund A., et al: Obstructed central venous catheters—Restoring function with a 12-hour infusion of low dose urokinase. Cancer66:2279-2285, 1990
29.
Tenenbaum L.: Cancer chemotherapy, a reference guide. Philadelphia, PA , Saunders, 1989
30.
Patient Guide: How to Care for your Hickman or Broviac Catheter . Cranston, RI, Davol Inc. (subsidiary of CR Bard, Inc)
