Highlights
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Long-term central venous access is crucial for many pediatric patients, and there is no consensus regarding the safety of port placement in infants under 1-year of age.
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This study demonstrates a low- or acceptable-risk of intra- and early post-operative complications associated with port placement in infants.
Abstract
Background
Long term central venous access is necessary for the treatment of several conditions
affecting young children. Totally implantable access ports (ports) offer the advantage
of containing no external components, thus simplifying their care and maintenance.
However, there is no consensus on the safety of port placement in infants (birth to
1-year of age). The aim of this study was to describe complications associated with
port placement in infants, including which specific factors may be associated with
risk for developing complications among these patients, and thereby assess the safety
of port placement in this young population.
Methods
A two-institution, retrospective cohort study identified patients under 1-year old
who underwent port placement. Intraoperative, early postoperative (within 30 days),
and late postoperative (greater than 30 days) complications were recorded. Multivariate
logistic regression models were employed to assess factors associated with port-related
complications.
Results
Among 121 patients who received a port, 36 (30%) experienced a complication with a
median time to complication of 299.5 days [IQR 67.5–440.75]. Of those, 26 required
unplanned port removal. Only 3 patients (2.5%) experienced an intraoperative complication,
and 3 patients (2.5%) experienced a complication within 30 days of port placement.
A diagnosis of cancer was found to be protective against early catheter malfunction
(OR=0.31, p = 0.03). A non-statistically significant trend associated with increased complications
for large caliber devices (>6.0Fr) and weight <7-kg (OR 2.20, p = 0.06 and OR=2.26, p = 0.11 respectively) was observed.
Conclusions
Port placement appears to be safe for most infants with low or acceptable rates of
intra- or post-operative complications. Smaller patient size (< 7 kg) and larger-sized
catheters (> 6.0Fr) may be associated with an increased risk for complications among
this population.
Level of evidence
III
Keywords
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Article info
Publication history
Published online: December 10, 2021
Accepted:
December 1,
2021
Received in revised form:
November 24,
2021
Received:
August 18,
2021
Identification
Copyright
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