Highlights
• The Central Line Securement Vest is a novel medical device for pediatric patients.

• This study presents a cohort of patients with intestinal failure who use the vest.

• We compare rates of multiple adverse events 12 months before and after vest usage.

• The rate of line infections and trauma were lower after vest usage.

• The remaining outcomes were comparable before and after vest usage.

Abstract
Background:

Tunneled central lines are used to deliver medications, hydration, and total parenteral nutrition. The current modality for their securement is by a transparent sterile adhesive. Mechanical line traumas, including line fissures, breaks and dislodgements, occur frequently in children. A novel device, the Central Line Securement Vest, was created to protect central lines from mechanical trauma.

Objective:

We present here our experience with the device and report its use in patients with intestinal failure treated at our institution.

Methods:

All patients who have used the Central Line Securement Vest at our institution during the last decade were identified. We reviewed the patients’ electronic records and compared the rate of line mechanical trauma, line infections, line replacements, Emergency Department (ED) visits, and hospital admissions for a period of 12 months before and after the use of the device.

Results:

Ten patients were identified. Four patients had purchased the device at the time of line insertion. Six patients had a period of time of line use before beginning use of the device. The rate of line traumas and infections decreased after using the device: 0.19 ± 0.15 vs 0.05 ± 0.04 trauma/month, pre– vs post–device use, P < 0.05. Similarly, the rate of line infections decreased post–device use: 0.18 ± 0.13 vs 0.09 ± 0.06 infections/month, pre– vs post–device use, P < 0.05. The rate of line replacements, ED visits, and hospital admissions were similar pre– and post–device use.

Conclusion:

We report here our institution’s experience with a novel central line securement device designed to protect the line from mechanical trauma.

Tunneled central lines are used to deliver medications, hydration, and total parenteral nutrition (TPN) to patients with various medical conditions. Tunneled central lines are catheters that are placed into a central vein via a subcutaneous tunnel between the insertion site and the targeted vasculature. Preferred sites for delivery of TPN are the internal jugular vein and subclavian vein, although the femoral veins can be employed as well. These lines terminate in the superior or inferior vena cava depending on the insertion site.1  In the pediatric population, some of the most common uses include long-term vascular access and pathologies such as states of malabsorption or malnutrition and oncologic or infectious conditions.2