Comparative Study of Histological Alterations in Intravascular Catheter Region with and without the Use of Local Corticosteroid

Abstract

Introduction: Central venous access is one of the most common procedures in pediatric surgery worldwide for infusion of antibiotics, electrolytes, chemotherapy, total parenteral nutrition, etc. Local regional complications due the permanence of venous catheters are described most frequently as: thrombosis, infection, edema and local cellulites, mobilization and catheter loss. As a result, the catheter must be prematurely removed. The use of local corticosteroid (Betamethasone) can be an alternative to lengthen the catheter maintenance. Aim: This study objective is to analyze perivascular inflammatory alterations in phlebotomies with polytetrafluoroethylene (20 GA) catheter in two periods of permanence 15 and 30 days with or without local Corticosteroid. Material & Method: 32 New Zealand adult rabbits were submitted to catheterization of the External Right Jugular Vein(RJV) and were divided in 4 groups: G1: with 8 rabbits’ catheters collected in the 15 th day, without corticosteroid use; G2: with 8 rabbits’ catheters collected in the 15 th day, with corticosteroid use; G3: with 8 rabbits’ catheters collected in the 30 th day, without corticosteroid use; G4: with 8 rabbits’ catheters collected in the 30 th day, with corticosteroid use; G5: Control was the contralateral vein of the rabbit itself. Results: G2 presented lower inflammatory incidence when compared to G1, despite this difference was not statistically significant ( p = 0.7333). G4 also displayed lower inflammatory incidence than G3, however it was not statistically significant ( p = 0.3571). When G1 and G3 were compared with G2 and G4, there was also lower incidence of the inflammatory process in those subjects using Betamethasone, although this difference was not statistically significant ( p = 0.3202). Conclusion: Betamethasone used in the vascular catheters insertion areas through phlebotomy can lessen local inflammatory manifestations of venous catheterizations.