PERIPHERALLY INSERTED CENTRAL CATHETERS (PICC): THE TWO YEAR EXPERIENCE AT A TERTIARY CHILDREN'S HOSPITAL. A REVIEW OF COMPLICATIONS AND THEIR RISK FACTORS

2015 ◽  
Vol 51 ◽  
pp. 11-12
Keyword(s):  
Risk Factors ◽  
Peripherally Inserted Central Catheters ◽  
Children's Hospital ◽  
Children’S Hospital ◽  
Central Catheters

A Model to Predict Central-Line–Associated Bloodstream Infection Among Patients With Peripherally Inserted Central Catheters: The MPC Score

2017 ◽  
Vol 38 (10) ◽  
pp. 1155-1166 ◽  
Author(s):  
Erica Herc ◽  
Payal Patel ◽  
Laraine L. Washer ◽  
Anna Conlon ◽  
Scott A. Flanders ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Model ◽  
Significant Risk ◽  
Hospital Medicine ◽  
Central Line ◽  
Cox Proportional Hazards Model ◽  
Operating Characteristics ◽  
Peripherally Inserted Central Catheters ◽  
Factors Associated ◽  
Central Catheters

BACKGROUNDPeripherally inserted central catheters (PICCs) are associated with central-line–associated bloodstream infections (CLABSIs). However, no tools to predict risk of PICC-CLABSI have been developed.OBJECTIVETo operationalize or prioritize CLABSI risk factors when making decisions regarding the use of PICCs using a risk model to estimate an individual’s risk of PICC-CLABSI prior to device placement.METHODSUsing data from the Michigan Hospital Medicine Safety consortium, patients that experienced PICC-CLABSI between January 2013 and October 2016 were identified. A Cox proportional hazards model with robust sandwich standard error estimates was then used to identify factors associated with PICC-CLABSI. Based on regression coefficients, points were assigned to each predictor and summed for each patient to create the Michigan PICC-CLABSI (MPC) score. The predictive performance of the score was assessed using time-dependent area-under-the-curve (AUC) values.RESULTSOf 23,088 patients that received PICCs during the study period, 249 patients (1.1%) developed a CLABSI. Significant risk factors associated with PICC-CLABSI included hematological cancer (3 points), CLABSI within 3 months of PICC insertion (2 points), multilumen PICC (2 points), solid cancers with ongoing chemotherapy (2 points), receipt of total parenteral nutrition (TPN) through the PICC (1 point), and presence of another central venous catheter (CVC) at the time of PICC placement (1 point). The MPC score was significantly associated with risk of CLABSI (P<.0001). For every point increase, the hazard ratio of CLABSI increased by 1.63 (95% confidence interval, 1.56–1.71). The area under the receiver-operating-characteristics curve was 0.67 to 0.77 for PICC dwell times of 6 to 40 days, which indicates good model calibration.CONCLUSIONThe MPC score offers a novel way to inform decisions regarding PICC use, surveillance of high-risk cohorts, and utility of blood cultures when PICC-CLABSI is suspected. Future studies validating the score are necessary.Infect Control Hosp Epidemiol2017;38:1155–1166

Percutaneously Inserted Polyurethane Central Catheters in the NICU: One Unit’s Experience

1999 ◽  
Vol 18 (6) ◽  
pp. 37-46 ◽  
Author(s):  
Martha Evans ◽  
Donna Lentsch
Keyword(s):  
Success Rates ◽  
Children's Hospital ◽  
Patient Demographics ◽  
Line Placement ◽  
Children’S Hospital ◽  
Central Catheters

This article describes the authors’ experiences with using polyurethane percutaneously inserted central catheters from June 1993, when these catheters were introduced in the NICU at Children’s Hospital, Omaha, Nebraska, through September 1997. Indications for line placement and anatomy are reviewed. Patient demographics, success rates, and complications are analyzed. Line cares, including dressing changes, management of infusions, and troubleshooting, are also discussed.

Risk factors and prognosis of emergency cesarean delivery at the Yaoundé Women's and Children's Hospital, Cameroon

2014 ◽  
Vol 24 (1) ◽  
pp. 89-93
Author(s):  
P. Foumane ◽  
V. Mve Koh ◽  
J. Ze Minkande ◽  
E.A. Njofang Ngantcha ◽  
J.S. Dohbit ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cesarean Delivery ◽  
Children's Hospital ◽  
Emergency Cesarean ◽  
Children’S Hospital

Early Onset versus Late Onset Peripherally Inserted Central Venous Catheter Infections: An Analysis of Risk Factors and Microbiology

2013 ◽  
Vol 34 (9) ◽  
pp. 980-983 ◽  
Author(s):  
Paul Chittick ◽  
Sobia Azhar ◽  
Kalyani Movva ◽  
Paula Keller ◽  
Judith A. Boura ◽  
...  
Keyword(s):  
Risk Factors ◽  
Central Venous Catheter ◽  
Early Onset ◽  
Late Onset ◽  
Bloodstream Infections ◽  
Venous Catheter ◽  
Central Venous ◽  
Peripherally Inserted Central Catheters ◽  
Catheter Infections ◽  
Central Catheters

The risks and microbiology for peripherally inserted central catheters (PICCs) are less well described than those for traditional central catheters, particularly as they pertain to duration of catheterization. We compared patients with early- and late-onset PICC bloodstream infections at our institution and found significant differences in microbiologic etiologies.

An Outbreak ofSalmonellaSerotype Saintpaul in a Children's Hospital

2002 ◽  
Vol 23 (11) ◽  
pp. 671-676 ◽  
Author(s):  
Rena Bornemann ◽  
Danielle M. Zerr ◽  
Joan Heath ◽  
Jane Koehler ◽  
Marcus Grandjean ◽  
...  
Keyword(s):  
Risk Factors ◽  
Medical Center ◽  
Multivariable Analysis ◽  
Continuous Variables ◽  
Exact Test ◽  
Children's Hospital ◽  
Regional Medical ◽  
Regional Medical Center ◽  
Children’S Hospital ◽  
Chisquare Test

Objectives:To describe a nosocomial outbreak ofSalmonellaserotype Saintpaul gastroenteritis and to explore risk factors for infection.Design:Case-control study.Setting:A 208-bed, university-affiliated children's hospital.Participants:Patients hospitalized at Children's Hospital and Regional Medical Center, Seattle, Washington, during February 2001 who had stool specimens obtained for culture at least 24 hours after admission. Case-patients (n = 11) were patients with an indistinguishable strain ofSalmonellaSaintpaul cultured from their stool. Control-patients (n = 41) were patients hospitalized for problems other than gastroenteritis whose stool cultures were negative forSalmonella.Methods:Risk factors were evaluated using the chisquare test or Fisher's exact test. Continuous variables were compared using the Mann–Whitney U test. A multivariable analysis was performed using logistic regression. The predictor of interest was the receipt of enteral feeding formula mixed by the hospital.Results:Case-patients were more likely than control-patients to have received formula mixed by the hospital (OR, 4.2; 95% confidence interval, 1.04 to 17.16). Other variables evaluated were not significant predictors ofSalmonellaSaintpaul infection.Conclusions:Formula mixed by the hospital appears to have been the source of thisSalmonellaoutbreak. Strict sanitation measures must be ensured in formula preparation and delivery, and bacterial pathogens should be included in the differential diagnosis for nosocomial gastroenteritis.

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