Skip to main content

Advertisement

SpringerLink
Log in

Tubes, Lines, and Stomas

  • General Surgery (D Carney, Section Editor)
  • Published:
Current Treatment Options in Pediatrics Aims and scope Submit manuscript

Opinion statement

The purpose of this study was to review the nomenclature, indications for placement, and anatomic location of medical support devices. Specifically, this review of enteric tubes, central venous lines, tracheostomy, and intestinal stomas includes novel treatment options for common complications. For example, a review of recent data suggests that central venous line salvage, in the setting of infection, is best managed with antibiotic lock therapy in addition to systemic antibiotics. This update of typical tubes, lines, and stomas is supported by a discussion of common complications and effective strategies for management.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

References and Recommended Reading

  1. Vogt W, Messmann H, Lock G, et al. CT-guided PEG in patients with unsuccessful endoscopic transillumination. Gastrointest Endosc. 1996;43:138.

    Article  CAS  PubMed  Google Scholar 

  2. Stiegmann GV, Goff JS, Silas D, et al. Endoscopic versus operative gastrostomy: final results of a prospective randomized trial. Gastrointest Endosc. 1990;36:1.

    Article  CAS  PubMed  Google Scholar 

  3. Larson DE, Burton DD, Schroeder KW, DiMagno EP. Percutaneous endoscopic gastrostomy. Indications, success, complications, and mortality in 314 consecutive patients. Gastroenterology. 1987;93:48.

    Article  CAS  PubMed  Google Scholar 

  4. Blomberg J, Lagergren J, Martin L, et al. Complications after percutaneous endoscopic gastrostomy in a prospective study. Scand J Gastroenterol. 2012;47:737.

    Article  PubMed  Google Scholar 

  5. Saavedra H, Losek JD, Shanley L, Titus MO. Gastrostomy tube-related complaints in the pediatric emergency department: identifying opportunities for improvement. Pediatr Emerg Care. 2009 Nov;25(11):728–32.

    Article  PubMed  Google Scholar 

  6. Goldberg E, Kaye R, Yaworski J, Liacouras C. Gastrostomy tubes: facts, fallacies, fistulas, and false tracts. Gastroenterol Nurs. 2005 Nov-Dec;28(6):485–93. quiz 493-4

  7. Chong VH. Gastric outlet obstruction caused by gastrostomy tube balloon. Indian J Gastroenterol. 2004;23:80.

    PubMed  Google Scholar 

  8. Agarwal A, Marks N, Wessel V, Willis D, Bai S, Tang X, Ward WL, Schellhase DE, Carroll JL. Improving knowledge, technical skills, and confidence among pediatric health care providers in the management of chronic tracheostomy using a simulation model. Pediatr Pulmonol. 2016 Jul;51(7):696–704. doi:10.1002/ppul. SSSSSSS23355. Epub 2015 Dec 17

  9. Blum LV, Abdel-Rahman U, Klingebiel T, Fiegel H, Gfroerer S, Rolle U. Tunneled central venous catheters in children with malignant and chronic diseases: a comparison of open vs. percutaneous implantation. J Pediatr Surg. 2017 Jan 30. pii: S0022-3468;(17):30078–7. doi:10.1016/j.jpedsurg.2017.01.045.

  10. Vegunta RK, Loethen P, Wallace LJ, Albert VL, Pearl RH. Differences in the outcome of surgically placed long-term central venous catheters in neonates: neck vs groin placement. J Pediatr Surg. 2005 Jan;40(1):47–51.

    Article  PubMed  Google Scholar 

  11. Des Jardin JA, Falagas ME, Ruthazer R, et al. Clinical utility of blood cultures drawn from indwelling central venous catheters in hospitalized patients with cancer. Ann Intern Med. 1999;131:641.

    Article  CAS  Google Scholar 

  12. Martinez JA, Des Jardin JA, Aronoff M, et al. Clinical utility of blood cultures drawn from central venous or arterial catheters in critically ill surgical patients. Crit Care Med. 2002;30:7.

    Article  PubMed  Google Scholar 

  13. Allon M. Treatment guidelines for dialysis catheter-related bacteremia: an update. Am J Kidney Dis. 2009;54:13.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Flynn PM, Shenep JL, Stokes DC, Barrett FF. In situ management of confirmed central venous catheter-related bacteremia. Pediatr Infect Dis J. 1987;6:729.

    Article  CAS  PubMed  Google Scholar 

  15. Wiener ES, McGuire P, Stolar CJ, et al. The CCSG prospective study of venous access devices: an analysis of insertions and causes for removal. J Pediatr Surg. 1992;27:155.

    Article  CAS  PubMed  Google Scholar 

  16. Baltimore RS. Neonatal nosocomial infections. Semin Perinatol. 1998;22:25.

    Article  CAS  PubMed  Google Scholar 

  17. Mermel LA, Allon M, Bouza E, et al. Clinical practice guidelines for the diagnosis and management of intravascular catheter-related infection: 2009 update by the Infectious Diseases Society of America. Clin Infect Dis. 2009;49:1.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  18. Saad TF. Bacteremia associated with tunneled, cuffed hemodialysis catheters. Am J Kidney Dis. 1999;34:1114.

    Article  CAS  PubMed  Google Scholar 

  19. Marr KA, Sexton DJ, Conlon PJ, et al. Catheter-related bacteremia and outcome of attempted catheter salvage in patients undergoing hemodialysis. Ann Intern Med. 1997;127:275.

    Article  CAS  PubMed  Google Scholar 

  20. Safdar N, Maki DG. Use of vancomycin-containing lock or flush solutions for prevention of bloodstream infection associated with central venous access devices: a meta-analysis of prospective, randomized trials. Clin Infect Dis. 2006;43:474.

    Article  PubMed  Google Scholar 

  21. Carratalà J, Niubó J, Fernández-Sevilla A, et al. Randomized, double-blind trial of an antibiotic-lock technique for prevention of gram-positive central venous catheter-related infection in neutropenic patients with cancer. Antimicrob Agents Chemother. 1999;43:2200.

    PubMed  PubMed Central  Google Scholar 

  22. Arenas Villafranca JJ, López-Rodríguez C, Abilés J, Rivera R, Gándara Adán N, Utrilla NP. Protocol for the detection and nutritional management of high-output stomas. Nutr J. 2015 May 9;14:45. doi:10.1186/s12937-015-0034-z.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Mackowski A, Chen HK, Levitt M. Successful management of chronic high-output ileostomy with high dose loperamide. BMJ Case Rep. 2015 Apr 22;2015. pii: bcr2015209411 doi:10.1136/bcr-2015-209411.

Download references

Author information

Authors and Affiliations

  1. Section of Pediatric Surgery, Mercer University School of Medicine, Memorial Health University Medical Center, 4750 Waters Avenue, Suite 307, Savannah, GA, 31404, USA

    David E. Carney MD

Authors
  1. David E. Carney MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to David E. Carney MD.

Ethics declarations

Conflict of Interest

David E. Carney declares that he has no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Additional information

This article is part of the Topical Collection on General Surgery

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Carney, D.E. Tubes, Lines, and Stomas. Curr Treat Options Peds 3, 118–127 (2017). https://doi.org/10.1007/s40746-017-0088-6

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s40746-017-0088-6

Keywords

Search

Navigation