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Amaç: Uzun süreli tedavi gerektiren kronik hastalıklarda hem tedavi devamını sağlamak hem de günlük kan örneği alımını kolaylaştırmak için kalıcı tünelli santral venöz kateterlere (KTK) ihtiyaç duyulur. Bu çalışmanın amacı çocuklarda ultrasonografi (USG) eşliğinde kalıcı tünelli kateter yerleştirilmesi işlemi ile ilgili olarak sonuçlarımızı değerlendirmek ve deneyimimizi aktarmaktır. Yöntem: Kliniğimizde 2015 ve 2020 yılları arasında USG-eşliğinde kalıcı tünelli kateter yerleştirilen hastaların dosyaları geriye dönük olarak tarandı. Hastaların demografik özellikleri gelişen kateter komplikasyonları ve kateter kalış süreleri değerlendirildi. Bulgular: Toplam 461 hasta çalışmaya dahil edildi. 296 (%57,7) erkek ve 195 (%42,3) kız hastadan oluşan grubun yaş ortalaması 10,6±4,04 olarak bulundu. Çalışma süresi içinde 409 hastaya bir kez, 41 hastaya 2 kez, 10 hastaya 3 kez ve 1 hastaya 4 kez olmak üzere 525 KTK takılmıştır. Gelişen komplikasyonlar nedeniyle toplam 56 kateter revizyonu yapıldı ve 8 hastaya da relaps nedeniyle tekrar kateter takıldı. Kateter revizyonlarının en önemli sebebini kateter enfeksiyonları oluşturuyordu (%55,3 n=31). Kateter kalış süreleri 1-489 gün arasında değişirken ortalama süre 204±119 gün olarak bulundu. Toplam kateter gün sayısı ise 107,165 kateter/gün olarak saptandı. Bu süre içinde kateter ilişkili toplam 360 enfeksiyon saptandı (3,35/1000 kateter/gün). En sık gram (+) kok enfeksiyonları saptanırken, Stafilococcus aureus (n=104) en sık izole edilen mikroorganizma idi. Sonuç: USG-eşliğinde kalıcı tünelli kateter takılması işleminin perioperatif komplikasyon oranları önemli ölçüde düşüktür. Yaş sınırı olmaksızın tüm çocuk hastalarda güvenle kullanılabilir. Kateter enfeksiyonları eğitimli personel ile en aza indirilebilir. İnternal juguler ven kateterizasyonunda giriş yeri olarak servikal bölgede klavikulanın hemen üzeri tercih edilirse katlanma ile ilgili sorunlar daha aza indirilebilir.
Purpose: In chronic diseases that require long-term treatment, persistent tunnel central venous catheters (CT) are needed to ensure continuity of treatment and facilitate daily blood sampling. The aim of this study is to evaluate our results and transfer our experience in relation to the process of placing permanent tunnel catheter accompanied by ultrasound (USG) in children. Method: In our clinic, the files of patients placed in a permanent tunnel catheter in the USG-like between 2015 and 2020 were scaned backward. The demographic characteristics of patients were evaluated by developing catheter complications and catheter stay periods. A total of 461 patients were included in the study. The average age of the group of 296 (57.7%) male and 195 (42.3%) female patients was 10.6±4.44. During the study period, 409 patients were introduced once, 41 patients were introduced 2 times, 10 patients were introduced 3 times and 1 patient was introduced 4 times. As a result of developing complications, a total of 56 cateters were reviewed and 8 patients were re-installed due to recurrence. The main cause of catheter revisions was catheter infections (55.3 % n=31). The catheter stay periods vary between 1-489 days, while the average time was 204±119 days. The total number of kateter days was 107,165 kateter/day. During this period, a total of 360 catheter-related infections were detected (3,35/1000 catheter/day). While the most frequently detected gram (+) cough infections, Stafilococcus aureus (n=104) was the most frequently isolated microorganism. The result: the rates of perioperative complications of the process of permanent tunnel catheter installation in the USG-compatibility are significantly low. It can be used safely in all children without age limit. Catheter infections can be minimized with trained staff. If it is preferred directly above the clavicular in the cervical area as the entrance place in the internal jugular vein catheterization, the problems related to tolerance can be reduced.
Objective: Permanent tunneled central venous catheters are required for long-term treatment, of the chronic diseases facility in the daily blood sampling. The aim of this study is to evaluate our results regarding the placement via ultrasonography (USG) of permanent tunneled catheter in children and to convey our experience. Method: The files of patients who were placed with USG-guided permanent tunneled catheters in our clinic between 2015 and 2020 years were retrospectively reviewed. The demographic characteristics of the patients, catheter complications and catheter length of stay were evaluated. Results: A total of 461 patients were included in the study. The mean age of the group was 10.6 ± 4.04 years. During the study period, 525 catheters had been inserted. A total of 56 catheter revisions were performed due to complications, and 8 catheters were reinserted due to relapse. Catheter infections were the common cause of catheter revisions (55.3% n = 31). While the catheter longevity ranged from 1 to 489 days, the average longevity was found 204 ± 119 days. The total catheter days was found 107,165 days. A total of 360 catheter-related infections were detected. Staphylococcus aureus (n = 104) was the most frequently isolated microorganism. Conclusion: Perioperative complication rates of USG-guided catheterization are significantly lower. It can be used safely in all pediatric patients without age limit. Catheter infections can be minimized with trained staff. Problems related to catheter bending can be reduced if just the preferred insertion side is used at the cervical region just above the clavicle.
Alan : Sağlık Bilimleri
Dergi Türü : Uluslararası
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