Browsing by Author "Stevanović, Vesna (57193986276)"

Introduction The Hickman catheter is a tunneled, open-type catheter often implanted in children for long-term intravenous treatment. Their application can cause numerous complications. Catheter breakage and dislocation of fragments to the intravascular system is a rare but life-threatening condition. When a complication occurs, depending on the patient’s clinical condition, the first step is transcutaneous endovascular removal of the catheter’s fragment. If this is not possible, surgical thoracotomy is necessary. The objective of this article was to present a case of breakage and dislocation of Hickman catheter in a pediatric patient, as well as the diagnostic and therapeutic approach to complications. Case outline We report a 14-month-old child who had a Hickman catheter because he was undergoing treatment for acute juvenile myelomonocytic leukemia. Due to a malfunction of the catheter, the existing catheter had to be removed. During the surgical procedure, a breakage and dislocation of the catheter fragment occurred. A chest X-ray and an echocardiography confirmed the position of the catheter fragment in the right atrium. A transcutaneous endovascular procedure was successfully performed to remove the fragment of the catheter. Conclusion Numerous complications can occur during the insertion, management, and removal of long-term catheters. It is necessary to periodically control the catheter’s position by chest X-ray and ultrasound of the heart and neck. If a particular complication is detected, an individual approach to treatment with the lowest risk to the patient should be chosen. Dislocated fragments of the Hickman catheter can be safely removed by endovascular transcatheter procedures. © 2024, Serbia Medical Society. All rights reserved.

Possible immune system interactions due to vaccination and drugs used in general anesthesia represent a dilemma for pediatric anesthesiologists in everyday practice. Immunosuppression caused by anesthesia and surgical trauma can affect the immunization process and cause-specific unwanted reactions. On the other hand, side effects due to vaccination can confuse clinicians in the immediate postoperative course. Both the nature of the vaccine and the type of surgery determines the delay period of elective surgical intervention. This current topic aims to present the scientific facts about the complex interactions between vaccination, immunization, general anesthesia, and surgical trauma and to provide recommendations for preoperative preparation. © 2023, Serbia Medical Society. All rights reserved.