Francisco BARROS, Catarina CHAVES, Patricia SANTOS, Helder PEREIRA, Joana Garcia AZEVEDO
The Journal of Pediatric Research - 2026;13(3):272-278
Aim: Central venous catheters (CVCs) are frequently used in paediatric neurosurgical procedures but are also associated with potentially serious complications. Sometimes, these complications are life-threatening or require the premature removal of the CVC, which may impair medical care. The aim of this study was to evaluate the incidence and characteristics of CVC-related complications in a paediatric neurosurgical population and to identify factors associated with their occurrence. Materials and Methods: We conducted a retrospective observational study including children who underwent neurosurgical procedures under general anaesthesia with intraoperative CVC placement at a single tertiary hospital between January 2017 and January 2022. Demographic data, clinical characteristics, catheter-related variables, and complications were collected from the electronic medical records. Complications were classified as either immediate or delayed. Associations between patient- and procedure-related factors and the occurrence of complications were analysed using appropriate statistical tests. Results: A total of 193 paediatric patients were included in the final analysis. The median age of the patients was 81.8 months. Overall, CVC-related complications occurred in 24 patients (12.4%). Delayed complications accounted for the majority of events (91.7%), with device dysfunction being the most frequent complication. Immediate complications were rare (8.3%). An American Society of Anesthesiologists Physical Status (ASA-PS) classification of 3 was significantly associated with a higher incidence of complications (p=0.038). No significant associations were found between complications and patient age, sex, catheter location, ultrasound guidance, or intraoperative blood product transfusion. Conclusion: In this paediatric neurosurgical cohort, CVC-related complications occurred in 12.4% of patients and were predominantly delayed, with device dysfunction being the most common event. Higher ASA-PS was the only factor associated with increased complication risks. These findings highlight the importance of careful postoperative catheter management and the necessity of ongoing CVC assessment in this vulnerable population.
