The use of central venous catheters in children receiving intensive oncotherapy in a developing country
Fifty-three central venous access catheters were placed in 45 consecutive cancer patients younger than 13 years of age. Ten of the 16 children from a very poor socio-economic background were discharged and received their catheter care as outpatients. Catheters were left in situ for a mean period of 134 days and 159 days in the better and poor socio-economic groups respectively. In 19 cases catheters were removed before completion of chemotherapy. Reasons for early removal of catheters were technical factors in 9 patients, removal by the patient in 4 cases, blocked catheters or skin erosion at the exit site in 4 cases, and catheter sepsis in 2 patients. One febrile episode was recorded per 107 catheter days. Blood culture-proven sepsis occurred at a rate of 1.7 episodes per 1000 catheter days. There was no difference in the incidence of febrile episodes without obvious cause in patients from a good socio-economic background (1/100 catheter days) and in those from a socio-economically disadvantaged background (1/123 catheter days). The morbidity in patients from poor socio-economic circumstances who went home with long-term central venous access catheters in situ was acceptable.