Pneumothorax Complicating Port-a-Cath and Groshong Catheter Positioning in Children: Our Experience before Routine Ultrasound-Guided PunctureReportar como inadecuado




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Objective: Tostudy incidence and management of long term central venous catheter CVCplacement related pneumothoraxPNX in children. Aim: To constructa baseline value before the introduction of systematic use of ultrasoundguidance, which requires specific training and equipment. Background: Anesthesia Service and Pediatric Oncology of the Italian National Cancer Center; patients werechildren age ≤ 18years with solid tumors, needing long-term central venous catheters Groshong or Port-a-Cath. Materials-Methods: Catheter placement was performed, mostly under general anesthesia,utilizing a micropuncture 5-7 Fr needle andfluoroscopy. In the study period ultrasound was used only in case of previouslyfailed attempts. Relevant data were collected retrospectively. Results: From August 2008 to December2011, 452 catheters were implanted to our patients. The prevalent approach wasfrom subclavian vein left 85.7%, right 9.7%;in few cases internal jugular vein was chosen right 2.4%, left 2.2%. Pneumothorax occurredin 14 patients 3.1%; 95%CI 1.9-5.1. In 4-14children the PNX was considered minimal and not treated. In 10 patients the PNXwas drained. In 7 cases a traditional, surgical thoracostomy was performed,while in 3 children a 14-Ga polyurethane catheter Arrow International®was inserted over a wire guide in the pleural space by anaesthetists. Conclusions: Inour centre rates of PNX are the same as those described in literature and areexpected to lower when ultrasound guidance of the puncture will be routinely applied. Percutaneous drainage of PNXseems as effective as surgically placed thoracostomy catheter, but lessinvasive.

KEYWORDS

Pneumothorax; Central Venous Catheter; Groshong; Port-a-Cath; Children; Drainage

Cite this paper

S. Guenzani, P. Previtali, F. Piccioni, M. Allemano, S. Catania and M. Langer -Pneumothorax Complicating Port-a-Cath and Groshong Catheter Positioning in Children: Our Experience before Routine Ultrasound-Guided Puncture,- Open Journal of Anesthesiology, Vol. 3 No. 8, 2013, pp. 345-348. doi: 10.4236-ojanes.2013.38073.





Autor: Silvia Guenzani, Paola Previtali, Federico Piccioni, Maria Chiara Allemano, Serena Catania, Martin Langer

Fuente: http://www.scirp.org/



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