424: Pediatric Pheresis Leg Splint Immobilization to Increase Efficiency Of Stem Cell Collection and Control Femoral Pheresis Catheter Malfunctions

Problem: Femoral pheresis catheter mafunction has been a recurring problem in the infant to three year old population at St. Louis Childrens Hospital. The very young pediatric patient would encounter problems with pheresis due to their inability to maintain leg alignment during the procedure, resulting in kinked and obstructed femoral pheresis lines. The pheresis line malfunctions often require second pheresis line placement, increase cost and length of hospital stay, increase sedation and sometimes result in missing peak collection dates due to the line malfunction. Plan: Prior to pheresis the patient was measured and a soft pheresis leg splint was designed to immobilize the patients leg in which the pheresis catheter would be placed. The pheresis leg splint was placed on the patient in the recovery room and remained in place until the pheresis process was completed. Evaluation: The evaluation of our experience with a active infant who underwent pheresis, while utilizing the pheresis leg splint, was very positive. The patient required three days of pheresis to meet the stem cell goal and the splint remained intact through out the process. The pheresis leg splint maintained the proper alignment and pheresis was performed without any catheter malfunctions. In the past it has been our experience that three days of pheresis in this age group would involve multiple line complications and those issues made for a frustrating pheresis experience for patient, family and healthcare providers. Future Plans: A research study will be conducted with patients from infant to three years of age using the pheresis leg splint and retrospectively comparing a similar population of patients and their pheresis outcomes. The catheter malfunction rate, cost and length of hospital stay, sedation requirements and pheresis cell count will be analyzed to determine the relevance of the pheresis leg splint in the very young noncompliant pediatric patient population.