150 Chapter 6 Abstract Background: Central venous catheter related complications, mainly central line associated bloodstream infections (CLABSI) and thrombosis, can complicate treatment of intestinal atresia or gastroschisis. Incidences and risk factors, e.g., location (central versus peripheral inserted) or mode of insertion (tunnelled versus non-tunnelled), of these complications are widely unknown. Therefore, we aim to identify the incidence of and risk factors for CLABSI and thrombosis in these patients. Methods: Children treated for intestinal atresia or gastroschisis between 1998-2021 at our tertiary referral center were retrospectively included. Risk factors for CLABSI were identified using logistic regression and the correlation between thrombosis and location/ mode of insertion was evaluated using chi2-tests. Results: In 238 patients, 35% developed CLABSI and 7% thrombosis. Treatment by enterostomy (OR:3.1;95%-CI:1.5–6.4) and non-tunnelled catheters (OR:2.0;95%- CI:1.3–4.6) significantly increased the CLABSI-risk whilst patient’s sex, catheter placement directly into central vein, preterm birth, trisomy 21, experiencing a major postoperative complication (Clavien-Dindo grade ≥III) and birthweight didn’t. Catheter dwell time was shorter (p<0.01) and CLABSIs developed faster (p=0.02) in non-tunnelled compared to tunnelled catheters. Catheter related thrombosis occurred more often in non-tunnelled catheters (p=0.03), whilst no correlation (p=0.34) was found between location of insertion. Conclusion: CLABSI occurs in approximately one third of the children treated for intestinal atresia or gastroschisis and a catheter related thrombosis occurs in one in fourteen. When in doubt which catheter to use in these patients, a tunnelled catheter is preferred over a non-tunnelled, specifically in case of enterostomy formation, since a tunnelled catheter is comparatively less at risk of catheter related infections and thrombosis.
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