PP310 Topic: AS06–Extracorporeal Organ Support: ECMO/Ventricular Assist Devices (Temporary & Durable)/MARS/Total Plasma Exchange/Plasmapheresis/Other: ASSESSMENT OF CENTRAL VENOUS CATHETER UTILIZATION AND COMPLICATION IN A TUNISIAN TERTIARY PEDIATRIC INTENSIVE CARE UNIT

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Aims & Objectives: Central venous catheters (CVC) represent devices commonly used in pediatric intensive care units. However, they are associated to multiple potentially severe complications. Aim: to evaluate indications and complications of CVC in children hospitalized in our pediatric intensive care unit. Methods: It is a prospective, and analytical study including all CVC inserted in children hospitalized in the pediatric intensive care unit of the pediatric department of Sahloul hospital during 26 months. Results: Our study included 85 CVCs inserted for 70 children. Most of them were indicated for parenteral nutrition and medication (94.1%). The femoral territory was the most frequently punctured site in our series (61 CVCs; 71.8%). Complications were observed in 35 CVCs: 23 CVCs (27%) presented infectious complications and 9 CVCs (10.6%) developed venous thrombosis. The specific incidence density of infectious complications was 19.43/1000 days, bacteremia was of 15.02/1000 days and CVC-related infections was of 6.76/1000 days. The specific incidence density of catheter-related thromboembolic complications was 7.6 CVC/1000 days. The common femoral vein was the most frequent site of CVC-related thrombosis. Univariate statistical analysis identified the following risk factors for CVC-related infections: CVC-associated thrombosis (p=0.007), plasmapheresis (p=0.029), length of stay (p=0.019) and duration of CVC use (p=0.0044). Conclusions: CVCs are a useful device in pediatric intensive care. However, they are frequently associated to multiple complications. Infectious complications are the most frequent complications observed. Prevention of catheter-related infection is essential, and requires a specific action in various factors involved in acquiring and transmitting infections. Keywords: intensive care, Sepsis, central venous catheterization, Children

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