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Master Thesis

Prise en charge des thromboses sur cathéter veineux ventral chez les enfants en nutrition parentérale à domicile. Évaluation des pratiques nationales et à l'Hôpital des enfants de Bordeaux

Abstract : Introduction: although central venous catheter (CVC) related thrombosis (CRT) is a severe complication of home parenteral nutrition (HPN) in children, the amount and quality of data in this area remain suboptimal. The aims of this study were to assess CRT management in French centers, and to search for characteristics associated with CRT amongst HPN children. Methods: we performed 2 studies. An online cross-sectional survey was distributed electronically to French HPN centers. A monocentric retrospective cohort including all children on HPN in Bordeaux University Hospital Center between 2008 and 2020 was conducted. Results: responses from 27 centers (21 pediatrics) were collected. We found high variability in the majority of pediatric centers answers to the cross-sectional survey, and these answers were often departed from published guidelines and from adult centers answers. Thirty patients and 140 CVC were included in our second study (38,030 CVC-days). Ten CRTs were diagnosed, amongst 23% of patients and 7.8% of tunneled CVC. Per 1000 CVC-days, 1.1 imaging for CRT research was performed, and 19% of them were positive. CVC type (CIP vs Broviac: OR=53.98 [IC95% 1.15 – 2544.57], p=0.04) and the number of CVC per patient (OR=1.61 [IC95% 1.00 – 2.60], p=0.05) were associated with CRT. We found a tendency for infection (OR=0.1 [IC95% 0.01 – 1.02], p=0.05) and S. aureus infection (OR=10.35 [IC95% 0.85 – 125.80], p=0.07) to be associated with CRT. Conclusion: CRT management varies widely amongst pediatric HPN centers. There is a need for collaborative research in this field.
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https://dumas.ccsd.cnrs.fr/dumas-02946717
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Submitted on : Wednesday, September 23, 2020 - 1:15:35 PM
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Julien Gotchac. Prise en charge des thromboses sur cathéter veineux ventral chez les enfants en nutrition parentérale à domicile. Évaluation des pratiques nationales et à l'Hôpital des enfants de Bordeaux. Sciences du Vivant [q-bio]. 2020. ⟨dumas-02946717⟩

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