Treatment of children with cancer often involves giving drugs, fluids and blood products through veins. In addition, small amounts of blood from the child are frequently needed for testing in the laboratory. All this can be achieved by inserting a central venous catheter (CVC) which is a small tube inserted via skin into the blood vessel in the neck or the armpit. This allows repeated testing and treatment of the child with cancer over a period of months while minimising the discomfort. The presence of CVC in the veins also leads to an increased risk of infections which can be life-threatening. Our review systematically assessed the research done on strategies to prevent these infections in children with cancer.
A total of three research studies were identified. Two studies showed that there may be a decrease in CVC-related blood infections if the space in the CVC was washed and filled at regular intervals with urokinase (a drug which dissolves blood clots) with/without heparin (a drug which prevents the formation of blood clots) compared to heparin alone. One study showed that changing the dressing which covered the skin at the insertion of CVC every 15 days rather than every 4 days did not lead to an increased removal of the CVC because they had become infected. No research studies were identified for several other potential strategies which could reduce CVC-related infections in children with cancer.