Central venous access device (CVAD) complications in Haemophilia with inhibitors undergoing immune tolerance induction: Lessons from the international immune tolerance study.
Haemophilia
; 21(5): e369-74, 2015 Sep.
Article
em En
| MEDLINE
| ID: mdl-26178581
ABSTRACT
INTRODUCTION:
Central venous access devices (CVADs) are frequently required as stable long-lasting venous access in children with haemophilia, especially those requiring immune tolerance induction (ITI) for inhibitors. CVAD infection is one of the most frequently reported catheter-related complications in this patient population.AIM:
Detailed review of CVAD complications from the International ITI (I-ITI) study and analysis of potential risk factors for such complications.METHODS:
Retrospective analysis of prospectively obtained data from the I-ITI study primarily focused on CVAD-related complications.RESULTS:
A total of 115 children were recruited and 183 CVADs were placed in 99 subjects resulting in 121,206 CVAD-days observed on-study. A total of 124 CVAD infections were reported in 41 of 99 (41%) subjects with an overall infection rate of 0.94 per 1000 CVAD-days (interquartile ranges 0-1.7). A similar number of infections were observed in the two treatment arms (median 2 and 3 in high dose and low dose respectively). Infections occurred more frequently in the presence of external catheters than with fully implanted catheters (P = 0.026). Infected patients were significantly younger at the time of CVAD insertion (median age 22 vs. 25 months, P = 0.020). Patients with Gram-positive infections were also significantly younger than those with Gram-negative infections (median age 17 vs. 25 months, P < 0.0001).CONCLUSION:
CVAD infection was the most common complication observed in children with severe haemophilia and inhibitors in the frame of the I-ITI study. Younger age at CVAD insertion and external CVAD were associated with higher risk for infection. ITI outcome was unaffected by CVAD infections.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Cateterismo Venoso Central
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Internacionalidade
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Hemofilia A
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Tolerância Imunológica
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Anticorpos
Tipo de estudo:
Etiology_studies
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Risk_factors_studies
Limite:
Child
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Child, preschool
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Humans
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Infant
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Newborn
Idioma:
En
Revista:
Haemophilia
Ano de publicação:
2015
Tipo de documento:
Article