ABSTRACT: The aim of this study was to retrospectively evaluate the frequency, severity, and risk factors associated with Hickman catheter-related complications rate, complication types, and outcome in children with acute leukemia at the largest pediatric tertiary care unit in Bosnia and Herzegovina.
Materials and Methods: A cross-sectional study was conducted on a cohort of pediatric acute leukemia patients who underwent Hickman central venous catheters (CVCs) between January 2019 and July 2024. Mechanical, infectious, and thrombotic Hickman catheter-related complications were evaluated and analyzed. We also investigated possible risk factors associated with these complications.
Results: Results: Ninety-one Hickman CVCs were inserted in 88 children (54 boys and 34 girls) at a mean age of 5.9 ± 4.6. Sixty (68%) children had acute limphoblast leukemia and 28 (32%) acute myeloid leukemia. The median follow-up after Hickman CVC insertion was 190 days (95% CI [160-212]) for 12 644 catheter days. During follow-up, 16 (18.1%) mechanical, 9 (11%) infectious and 7 (8%) thrombotic complications were recorded (1.6, 0.9, and 0.7 for mechanical, infectious, and thrombotic complications per 1000 catheter days, respectively). A slightly higher incidence of complications was recorded in children with acute myeloid leukemia (1.59 per 1000 catheter days) compared with children with s acute limphoblastic leukemia (1.22 complications per 1000 catheter days).
Conclusion: Using Hickman CVCs for long-term venous access in infusional chemotherapy for pediatric cancer patients is safe but is associated with significant morbidity. All health care professionals, including physicians and nurses, caring for children with CVCs should be aware of potential complications and should receive regular and continued education on CVC usage, complications, and insertion.
Keywords: Hickman Catheter Related Complications, Pediatric Acute Leukemia Patients
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