PhD Defense: Optimization of central venous access care in pediatric oncology patients

The insertion of a central line offers numerous advantages over a peripheral IV; however, we still observe significant adverse effects that have a major impact. This necessitates the development of specific pediatric oncology guidelines. The initial steps toward achieving this have been taken through the studies conducted in this thesis.

In the first section, we conducted a comprehensive analysis of the status of central line care for pediatric oncology patients in the Netherlands. Based on this analysis, we developed a surgical central line guideline and identified central line infections as the primary complication that needs to be prevented.

In the second section, initial steps were taken to prevent these infections through the use of taurolidine locks. Taurolidine locks were found to be no more effective than the current standard heparin locks in preventing infections. Future research will need to determine whether more frequent administration of these locks, administration to high-risk patients, or use in the treatment of infections is effective.

In the final section, we focused on optimizing the treatment of central line infections caused by a specific group of bacteria. We found that negative outcomes were common when these infections were treated solely with antibiotics, indicating that immediate line removal is recommended in such cases. Consequently, the guidelines in our hospital were adjusted accordingly.