Advanced

The impact of clinical practice on the outcome of central venous access devices in children with haemophilia

Khair, Kate; Ranta, S; Thomas, A. and Lindvall, Karin LU (2017) In Haemophilia 23(4). p.276-281
Abstract

Introduction: Central venous access devices facilitate home treatment in boys with haemophilia. These are usually fully implanted lines, referred to as ports. Caregivers are taught to manage the port using sterile techniques and maintaining patency by flushing with saline or heparin solution. National and international guidelines for the home care of ports are lacking. Aim: To evaluate if infection or occlusion rates differ between home care regimens used for ports in children with haemophilia. Methods: Children with ports were identified from the PedNet registry. Data on the homecare policy were acquired from each centre. To ensure a complete data set for each port, only ports that had been removed were included in the study. Three... (More)

Introduction: Central venous access devices facilitate home treatment in boys with haemophilia. These are usually fully implanted lines, referred to as ports. Caregivers are taught to manage the port using sterile techniques and maintaining patency by flushing with saline or heparin solution. National and international guidelines for the home care of ports are lacking. Aim: To evaluate if infection or occlusion rates differ between home care regimens used for ports in children with haemophilia. Methods: Children with ports were identified from the PedNet registry. Data on the homecare policy were acquired from each centre. To ensure a complete data set for each port, only ports that had been removed were included in the study. Three care groups were defined: ‘aseptic non touch technique’, ‘sterile technique’ and ‘fully sterile technique’. Outcomes within and between the groups were analysed. Results: A total of 240 children with 352 ports were studied. Insertion occurred at a median age of 1.32 years. The median port duration was 2.94 years with a total of 215 688 port days in children without and 183 852 in children with inhibitors. Infection was the most common cause of port removal (34%); there was no significant difference with infection as reason for removal between the different care groups. Occlusion was not more frequent in centres that did not use heparin. Conclusion: Use of sterile gloves and gowns did not reduce the risk of port infection. Using less stringent sterile techniques for accessing ports is easier for caregivers and in addition may have health economic benefits.

(Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
central venous access device, children, haemophilia, nursing practice
in
Haemophilia
volume
23
issue
4
pages
276 - 281
publisher
Federation of European Neuroscience Societies and Blackwell Publishing Ltd
external identifiers
  • scopus:85024499246
  • wos:000405873900004
ISSN
1351-8216
DOI
10.1111/hae.13241
language
English
LU publication?
yes
id
0f262629-f4af-4d26-8eeb-e1e0d5e6b1f1
date added to LUP
2017-08-07 11:55:24
date last changed
2017-09-18 11:41:02
@article{0f262629-f4af-4d26-8eeb-e1e0d5e6b1f1,
  abstract     = {<p>Introduction: Central venous access devices facilitate home treatment in boys with haemophilia. These are usually fully implanted lines, referred to as ports. Caregivers are taught to manage the port using sterile techniques and maintaining patency by flushing with saline or heparin solution. National and international guidelines for the home care of ports are lacking. Aim: To evaluate if infection or occlusion rates differ between home care regimens used for ports in children with haemophilia. Methods: Children with ports were identified from the PedNet registry. Data on the homecare policy were acquired from each centre. To ensure a complete data set for each port, only ports that had been removed were included in the study. Three care groups were defined: ‘aseptic non touch technique’, ‘sterile technique’ and ‘fully sterile technique’. Outcomes within and between the groups were analysed. Results: A total of 240 children with 352 ports were studied. Insertion occurred at a median age of 1.32 years. The median port duration was 2.94 years with a total of 215 688 port days in children without and 183 852 in children with inhibitors. Infection was the most common cause of port removal (34%); there was no significant difference with infection as reason for removal between the different care groups. Occlusion was not more frequent in centres that did not use heparin. Conclusion: Use of sterile gloves and gowns did not reduce the risk of port infection. Using less stringent sterile techniques for accessing ports is easier for caregivers and in addition may have health economic benefits.</p>},
  author       = {Khair, Kate and Ranta, S and Thomas, A. and Lindvall, Karin},
  issn         = {1351-8216},
  keyword      = {central venous access device,children,haemophilia,nursing practice},
  language     = {eng},
  month        = {07},
  number       = {4},
  pages        = {276--281},
  publisher    = {Federation of European Neuroscience Societies and Blackwell Publishing Ltd},
  series       = {Haemophilia},
  title        = {The impact of clinical practice on the outcome of central venous access devices in children with haemophilia},
  url          = {http://dx.doi.org/10.1111/hae.13241},
  volume       = {23},
  year         = {2017},
}