#49: Results of 10 Years of Peripherally Inserted Central Catheter Use and the Association with Infections in Pediatric Patients at a Tertiary Care Oncology Hospital

2021 ◽  
Vol 10 (Supplement_1) ◽  
pp. S16-S16
Author(s):  
Jennia J Acebo ◽  
María Costta ◽  
Gisella Sánchez ◽  
Erika Villanueva ◽  
Erika Montalvo E ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Complication Rate ◽  
Best Practice ◽  
Infectious Complication ◽  
Pediatric Patients ◽  
Tertiary Care ◽  
Bloodstream Infections ◽  
Complication Rates ◽  
Peripheral Venous Access ◽  
Pediatric Cancer Patients

Abstract Introduction Pediatric cancer patients merit the placement of central lines for the treatments they receive. Subcutaneous central ports (SCs) and peripherally inserted central catheters (PICCs) are the most frequently used lines. PICCs have gained popularity due to the ease of insertion, which can be invaluable in the pediatric oncology setting for administration of intravenous therapy, parenteral nutrition, and/or blood products. Since central-line-associated bloodstream infections increase the morbidity and mortality of cancer patients, as well as increase the cost generated by their treatment, active surveillance of these healthcare-associated infections is warranted. Methods This is a retrospective descriptive study of pediatric patients treated via PICCs at the Hospital SOLCA Núcleo Quito between 2009 and 2019. Results During the study period, 70 PICC lines were placed in 66 patients, totaling 1862 catheter-days. The majority of patients (75.7%) were diagnosed with leukemia or lymphoma. As of 2011, all PICCs were placed in the operating room by a surgeon. Ultrasound was used 39 times for the insertion of PICCs. Inadequate peripheral venous access was the most common indication (64.2%) for placement. Twenty-nine PICCs had complications, of which 13 were infectious complications and 16 were noninfectious. The most common infectious complication was PICC-related bloodstream infection (13), and the most frequent noninfectious complication was occlusion (10). The overall complication rate was 15.5 complications per 1000 catheter-days, and the overall infectious complication rate was 6.9 complications per 1000 catheter days. Annual complication rates fluctuated over the study period. The PICC line-associated infection rate per 1000 catheter-days was 13.1‰ in 2009, 12.4‰ in 2010, 5.0‰ in 2011, 7.9‰ in 2012, 0 in 2013, 13.4‰ in 2014, 4.8‰ in 2015, 16.2‰ in 2016, 8.2‰ in 2017, and 4.3‰ in 2018. Conclusion In general, complications related to PICC in pediatric patients at a tertiary care oncology hospital have fluctuated over the years. Our findings indicate the need for further efforts in staff education and training in the insertion, care, and maintenance of PICC lines. Best practice guidelines are also critical to reducing complications, especially occlusion and infection rates, to thereby improve patient outcomes.

scholarly journals Profile of Bloodstream infections in Pediatric cancer patients at a tertiary care center

2017 ◽  
Vol 2 (2) ◽  
pp. S26-S27
Author(s):  
Purva Kanvinde ◽  
Mohammed Naseer ◽  
Sangeeta Mudaliar ◽  
Archana Swami ◽  
Bharat Agrawal
Keyword(s):  
Cancer Patients ◽  
Pediatric Cancer ◽  
Care Center ◽  
Tertiary Care ◽  
Bloodstream Infections ◽  
Tertiary Care Center ◽  
Pediatric Cancer Patients

Family history of cardiovascular disease and cardiovascular comorbidities risk in a pediatric cancer population.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. 10518-10518
Author(s):  
Thomas Patrick Curtin ◽  
Wendy Kohlmann ◽  
Luke Devon Maese ◽  
Zhe Yu ◽  
Karen Curtin ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Family History ◽  
Cancer Patients ◽  
Pediatric Cancer ◽  
Pediatric Patients ◽  
Cvd Risk ◽  
First Degree Relatives ◽  
Pediatric Cancers ◽  
Pediatric Cancer Patients ◽  
History Of

10518 Background: Survival rates for childhood cancer patients have improved dramatically, but the growing survivor population suffers from increased treatment-related toxicity including high risk for cardiovascular disease (CVD). While the link between chemotherapy and radiation to cardiotoxicity is well established, few studies seek to determine if an underlying familial risk for cardiovascular disease contributes or predicts this risk. The Utah Population Database (UPDB) is a genealogical resource linked to statewide cancer diagnoses and electronic medical data in which family history is objectively determined. Methods: We calculated the risk of subsequent CVD (ICD-9 401-449) in relatives of 5602 pediatric cancer patients diagnosed at ages 0-19 in Utah from 1966-2013 with no congenital CVD-related anomalies (ICD-9 745-747, 758-759). We identified 964 patients with subsequent CVD diagnoses. Cox models provided recurrence-risk estimates in first-degree relatives of patients compared to relatives of 5:1 matched controls. Results: Pediatric cancer patients were at 5-fold risk of CVD compared to controls ( P< 10-15). In pediatric patients with subsequent CVD, first-degree relatives were at 30% increased CVD risk compared to relatives of cancer-free controls (HR = 1.31, 95%CI 1.16-1.47; P< 10-5). In pediatric patients without CVD, only parents exhibited slight CVD risk (HR = 1.08, 95%CI 1.03-1.14; P= 0.002). In 685,000 individuals with a non-congenital CVD history, pediatric cancers among their first-degree relatives were associated with a similar increased risk of subsequent CVD, compared to pediatric cancers among relatives of controls with no CVD events (HR = 1.39, 95%CI 1.18-1.64, P< 10-4). Conclusions: The UPDB is powerful for investigating comorbidities in cancer patients and their families without recall bias from self-reported family medical history. A family history of CVD may increase risk of CVD-related comorbidities among pediatric cancer patients by 30-40% beyond that observed in patients without a CVD family history. This finding suggests that in addition to a cancer family history, a CVD-related family history should be assessed in children diagnosed with cancer.

scholarly journals Central line bundle including split-septum device and single use prefilled flushing syringes for prevention of port associated bloodstream infections: A cost and resource utilization analysis

2019 ◽  
Author(s):  
Ilker Devrim ◽  
Mustafa T Ozkul ◽  
İlknur Çağlar ◽  
Yeliz Oruç ◽  
Nevbahar Demiray ◽  
...  
Keyword(s):  
Line Bundle ◽  
Cancer Patients ◽  
Pediatric Cancer ◽  
Bloodstream Infections ◽  
Central Line ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Pediatric Cancer Patients ◽  
Central Line Bundle

Abstract Background: Central line bundle programs were found to be effective in decreasing central line–associated bloodstream infection rates in pediatric cancer patients with ports. However cost-effectiveness studies of central line bundle programs in pediatric cancer patients are limited and most available data are from intensive care unit or adult studies. Methods: In this 6 years cross-sectional study, comprehensive assessment of total health care costs attributable to CLABSI’s associated with ports between two periods including 3 years of pre-bundle period and bundle period. Results: This cross-sectional study was carried out in the pediatric hematology-oncology ward of Dr. Behçet Uz Children’s Hospital from 1 August November 2011 to 31 July 2017. The CLABSI rates decreased significantly from 8,31 CLABSIs to 3.04 per 1000 central line days ( p <0.0001). In the prebundle period, total attributable costs spent for of patients with CLABSI were $130661,68 and in the bundle period, total attributable costs spent for patients with CLABSI were $116579,05.Within bundle implantation, 71 potential CLABSI were prevented which saved an additional $208977,81. In other words, for one dollar spent for bundle program, $ 6,54 was saved by decreasing the expected CLABSI. Conclusion: our study shows that central line bundles decreases not only the CLABSI rate, but also decreases attributable costs due to CLABSI. Expenses spent for bundle elements, were covered by savings by preventing CLABSI with higher costs

scholarly journals Febrile neutropenia management in pediatric cancer patients at Ethiopian Tertiary Care Teaching Hospital

2019 ◽  
Author(s):  
Husnia Bedewi ◽  
Malede Berihun ◽  
Atalay Mulu ◽  
Tamrat Assefa
Keyword(s):  
Febrile Neutropenia ◽  
Cancer Patients ◽  
Pediatric Cancer ◽  
Management Practice ◽  
Tertiary Care ◽  
Tikur Anbessa Specialized Hospital ◽  
Definitive Therapy ◽  
Pediatric Cancer Patients ◽  
Culture And Sensitivity ◽  
Study Participants

Abstract Objective This study aimed at assessing the management practice of febrile neutropenia (FN) in pediatric cancer patients at Tikur Anbessa Specialized Hospital (TASH), Ethiopia by reviewing patients’ charts from 135 participants retrospectively. Data was entered into Epi-info 7 and exported to SPSS 20 for analysis. Results Empiric antibiotics therapy (EAT) was given to all patients in which ceftriaxone with gentamycin constituted of 71.9% followed by ceftriaxone monotherapy. EATs were converted to others in 20 (14.8%) and 2(1.5%) patients for the first and second times respectively, mainly based on poor clinical response without conducting culture and sensitivity tests. These tests were done only for 13 (9.6%) participants and growth was seen in 5 patients; and definitive therapy was given for 2 patients. ANC value was above 500 cell/mm3 in 80.7% of patients and 98.5% of study participants were afebrile after completion FN treatment. Most of them (70.4%) were treated for FN and 7 of patients died due to all case mortality. The hospital should not rely mainly only on ceftriaxone with gentamycin as EAT and also should do culture and sensitivity test to optimize therapy based on susceptibility result before conversion and modification of therapy in management of FN.

Pediatric External Auditory Canal Foreign Bodies: A Review of 698 Cases

2002 ◽  
Vol 127 (1) ◽  
pp. 73-78 ◽  
Author(s):  
Stacey L. Schulze ◽  
Joseph Kerschner ◽  
David Beste
Keyword(s):  
Patient Outcomes ◽  
External Auditory Canal ◽  
Foreign Bodies ◽  
Pediatric Patients ◽  
Tertiary Care ◽  
Patient Characteristics ◽  
Complication Rates ◽  
Direct Visualization ◽  
Success Rates ◽  
Poor Outcomes

OBJECTIVE: The study goal was to determine the relationships between patient management factors and patient outcomes in pediatric patients with external auditory canal foreign bodies. STUDY DESIGN AND SETTING: Retrospective analysis was conducted of 698 consecutive cases of pediatric external auditory canal foreign bodies (n = 605 patients) who presented to a tertiary care pediatric referral center during a 6-year period. RESULTS: Emergency physicians frequently removed foreign bodies under direct visualization while otolaryngologists primarily used otomicroscopy. Both of these methods had high success rates overall (77% and 86%), but attempts under direct visualization had lower success rates with removing spherical objects, objects touching the tympanic membrane, and objects in the canal for more than 24 hours. Failed removal attempts resulted in higher complication rates. CONCLUSION: Certain foreign body and patient characteristics are associated with poor outcomes with removal attempts made under direct visualization. These cases should be referred directly to otolaryngologists for otomicroscopic removal.

Bloodstream infections and inpatient length of stay among pediatric cancer patients with febrile neutropenia in Mexico City

2014 ◽  
Vol 42 (11) ◽  
pp. 1235-1237 ◽  
Author(s):  
Martha Avilés-Robles ◽  
Rohit P. Ojha ◽  
Miriam González ◽  
Karla Ojeda-Diezbarroso ◽  
Elisa Dorantes-Acosta ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Febrile Neutropenia ◽  
Cancer Patients ◽  
Mexico City ◽  
Pediatric Cancer ◽  
Bloodstream Infections ◽  
Pediatric Cancer Patients ◽  
Inpatient Length Of Stay

scholarly journals LINC-01. COMPLIANCE TO FOLLOW UP IN PEDIATRIC PATIENTS WHO HAVE RECEIVED CRANIOSPINAL IRRADIATION

2020 ◽  
Vol 22 (Supplement_3) ◽  
pp. iii378-iii378
Author(s):  
Khin Pyone ◽  
Thwe Tun ◽  
Yin Win ◽  
Aye Thinn ◽  
Khin Win ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Pediatric Cancer ◽  
Pediatric Patients ◽  
Tertiary Hospital ◽  
Craniospinal Irradiation ◽  
Long Term Effects ◽  
Pediatric Cancer Patients ◽  
Need To Evaluate

Abstract OBJECTIVE Attendance to follow-up after completion of cancer treatment is understudied area. Pediatric cancer patients have sequelae of illness or treatment. Many have no symptom immediately after completion of treatment. Long term follow-up is important to access disease control, early diagnosis of recurrence, second cancer and treatment-related morbidities. Purpose of this study was to evaluate the compliance to follow-up in pediatric patients treated with craniospinal irradiation (CSI). METHODS This was retrospective review of follow-up in pediatric neuro-oncology patients who received (CSI) from January 2017 to June 2018 in the Radiotherapy Department of Yangon General Hospital, Myanmar. RESULT: Twenty-three patients received CSI; majority (43%) were medulloblastoma. Median age was 7.5 years (3–17 years). Only seven patients (30.4%) were attended to follow-up more than 6 months after completion of treatment. More than two-thirds of patients (n=16,69.6%) were lost to follow-up. Patients in active follow-up were diagnosed and treated at earlier age below 10years (n=5,21.7%). Demographically, 5 patients (22%) were living in the region around tertiary hospital. Sixteen patients (69.6%) from rural area had limited transportation and difficulty for accommodation in which they were treated. In socioeconomic points, 18 parents (78.2%) had poor education and financial status, lack of understanding about disease, treatment, long-term effects and follow-up. CONCLUSION Although this was limited data in CSI patients only, loss to follow-up after 6 months was high. We need to evaluate in all pediatric cancer patients and collaborate to provide financial support, childcare centres for lodging, transportation and health education to promote compliance to follow-up.

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