Central venous catheter for hemodialysis: incidence of infection and risk factors

ABSTRACT Objective: To measure the incidence of infection in short-term central venous catheter for hemodialysis and to identify the associated risk factors. Method: Prospective cohort study conducted in a teaching hospital from September 2015 to April 2016. Patients requiring central venous catheter for hemodialysis were included and data was collected through direct and systematic observation of the catheter insertion procedure by the researchers. Results: The final sample consisted of 69 patients, who used 88 catheters. The incidence of infection was 9.1%, and the risk factors were length of hospital stay and insertion of the catheter in the left femoral vein. Conclusion: The observation of the actions performed during the insertion of the catheter made it possible to identify the risk factors associated with infection, and the research protocol may have contributed to the reduction of infection rates.

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Risk factors for central venous catheter related bloodstream infection: a multicenter study of intensive care unit and haemodialysis unit

Bangladesh Medical Journal ◽

10.3329/bmj.v47i1.42819 ◽

2019 ◽

Vol 47 (1) ◽

pp. 18-21

Author(s):

Zeenat Afroz ◽

Mohammad Jobayer ◽

Md Ferdous Mian ◽

Farook Ahamed ◽

Mizanur Rahman ◽

...

Keyword(s):

Risk Factors ◽

Central Venous Catheter ◽

Femoral Vein ◽

Venous Catheter ◽

Blood Stream ◽

Cross Sectional Study ◽

Central Venous ◽

College Hospital ◽

Cross Sectional ◽

Factors Affecting

The clinical condition of the patient, type of central venous catheter (CVC), site and duration of CVC placement are the factors affecting the risk of infection. The aim of this study was to examine and find out the risk factors of CVC related blood stream infections (CVC-BSI). This cross sectional study was carried out in the Department of Microbiology and Immunology of Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh during the period of July 2011 to June 2012. One hundred patients who were admitted in ICU of BSMMU and ICU and haemodialysis unit of Dhaka Medical College Hospital (DMCH) having central venous catheter, were enrolled in the study. The rate of CVC-BSI was 11% and the incidence was observed to be 11.14/1000 catheter days. Both CVC-BSI and CVC colonization were higher in trilumen than in bilumen central venous catheter. CVC-BSI rate was 12.79% in trilumen whereas there was no CVC-BSI in patient with bilumen catheter. The mean duration from CVC insertion to development of CVC-BSI was 14 days, CVC colonization was 8.41 days and noninfected CVC was 6 days. CVC-BSI and CVC colonization were most common in right femoral vein where CVC-BSI was 18.52% and CVC colonization was 59.26%, whereas no CVC-BSI was found in right internal jugular vein. Risk factors for CVC-BSI included type of CVC, site of CVC placement, duration of catheterization were not found statistically significant in this study. CVC-BSI and CVC colonization were higher in trilumen catheter and rate raised with increased duration of placement and highest number of CVC-BSI and colonization was found in right femoral vein. Bangladesh Med J. 2018 Jan; 47 (1): 18-21

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Risk Factors of Central Venous Catheter-Related Bloodstream Infection for Continuous Renal Replacement Therapy in Kidney Intensive Care Unit Patients

Blood Purification ◽

10.1159/000495024 ◽

2018 ◽

Vol 48 (2) ◽

pp. 175-182 ◽

Cited By ~ 3

Author(s):

Shuiqin Cheng ◽

Shutian Xu ◽

Jinzhou Guo ◽

Qunpeng He ◽

Aijuan Li ◽

...

Keyword(s):

Risk Factors ◽

Central Venous Catheter ◽

Jugular Vein ◽

Femoral Vein ◽

Venous Catheter ◽

Central Venous ◽

Icu Patients ◽

Indwelling Time ◽

Vein Catheterization

Background: The incidence of central venous catheter-related bloodstream infection (CRBSI) for continuous renal replacement therapy (CRRT) in kidney intensive care unit (ICU) patients is worthy of particular attention and recently, we analyzed clinical characteristics and risk factors of CRBSI for CRRT in our kidney ICU patients. Methods: To be part of this retrospective study, 1,523 patients who had a central venous catheter (CVC) for CRRT during the period April 2010 to May 2015 in our centre were enrolled. The clinical features and pathogens of CRBSI patients were investigated. Patients who also had CRRT of kidney ICU hospitalization without CRBSI were enrolled in a 1: 2 ratio as control. Risk factors of the CRBSI were analyzed. Results: A total of 57 patients had central venous CRBSI. The incidence of the infection was 3.7%. The mean rate of CRBSI was 3.9 per 1,000 catheter days, and the catheter median indwelling time was 14 (7–30) days. The most common pathogens were Gram-positive bacteria, which were noted in 29 cases (50.9%), followed by Gram-negative bacteria (36.8%). The most common pathogens causing CRBSI were Staphylococcus aureus (10 cases) and sewer enterobacteriaceae (10 cases) followed by Staphylococcus epidermidis (9 cases). CVC insertion sites included internal jugular vein (33 cases) and femoral vein (24 cases), accounting for 2.9% of internal jugular vein catheterization (1,140 cases) and 6.3% of femoral vein catheterization (383 cases) respectively. In total, 16, 20, 7 and 14 cases of CRBSI were noted in Spring, Summer, Autumn and Winter, accounting for 28.1, 35.1, 12.3 and 24.6% respectively. The most common infectious manifestations were chills (68.4%), fever (100%), and septic shock (49.1%). Multivariate analysis showed that catheterization of the femoral vein, long catheter indwelling time, low CD4+ lymphocytes and high acute physiology and chronic health evaluation (APACHE) II scores were independent factors associated with CRBSI. Conclusions: The incidence of CRBSI in our kidney ICU was 3.7%. Central venous CRBSI for CRRT was associated with catheterization of the femoral vein, long catheter indwelling time, compromised immune function and high APACHE II scores. Understanding pathogens and risk factors for central venous CRBSI in kidney ICU can help doctors prevent and treat CRBSI earlier.

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Risk factor identification and predictive models for central line requirements for patients on vasopressors

Anaesthesia and Intensive Care ◽

10.1177/0310057x211024258 ◽

2021 ◽

pp. 0310057X2110242

Author(s):

Adrian D Haimovich ◽

Ruoyi Jiang ◽

Richard A Taylor ◽

Justin B Belsky

Keyword(s):

Risk Factors ◽

Intensive Care Unit ◽

Logistic Regression ◽

Intensive Care ◽

Central Venous Catheter ◽

Single Agent ◽

Composite Endpoint ◽

Venous Catheter ◽

Central Venous Catheters ◽

Central Venous

Vasopressors are ubiquitous in intensive care units. While central venous catheters are the preferred route of infusion, recent evidence suggests peripheral administration may be safe for short, single-agent courses. Here, we identify risk factors and develop a predictive model for patient central venous catheter requirement using the Medical Information Mart for Intensive Care, a single-centre dataset of patients admitted to an intensive care unit between 2008 and 2019. Using prior literature, a composite endpoint of prolonged single-agent courses (>24 hours) or multi-agent courses of any duration was used to identify likely central venous catheter requirement. From a cohort of 69,619 intensive care unit stays, there were 17,053 vasopressor courses involving one or more vasopressors that met study inclusion criteria. In total, 3807 (22.3%) vasopressor courses involved a single vasopressor for less than six hours, 7952 (46.6%) courses for less than 24 hours and 5757 (33.8%) involved multiple vasopressors of any duration. Of these, 3047 (80.0%) less than six-hour and 6423 (80.8%) less than 24-hour single vasopressor courses used a central venous catheter. Logistic regression models identified associations between the composite endpoint and intubation (odds ratio (OR) 2.36, 95% confidence intervals (CI) 2.16 to 2.58), cardiac diagnosis (OR 0.72, CI 0.65 to 0.80), renal impairment (OR 1.61, CI 1.50 to 1.74), older age (OR 1.002, Cl 1.000 to 1.005) and vital signs in the hour before initiation (heart rate, OR 1.006, CI 1.003 to 1.009; oxygen saturation, OR 0.996, CI 0.993 to 0.999). A logistic regression model predicting the composite endpoint had an area under the receiver operating characteristic curve (standard deviation) of 0.747 (0.013) and an accuracy of 0.691 (0.012). This retrospective study reveals a high prevalence of short vasopressor courses in intensive care unit settings, a majority of which were administered using central venous catheters. We identify several important risk factors that may help guide clinicians deciding between peripheral and central venous catheter administration, and present a predictive model that may inform future prospective trials.

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Risk factors for central venous catheter-related infections in pediatric intensive care

Clinics ◽

10.1590/s1807-59322007000500002 ◽

2007 ◽

Vol 62 (5) ◽

Cited By ~ 12

Author(s):

Ricardo Vilela ◽

Andréa D N Jácomo ◽

Antonia Teresinha Tresoldi

Keyword(s):

Risk Factors ◽

Intensive Care ◽

Central Venous Catheter ◽

Pediatric Intensive Care ◽

Venous Catheter ◽

Central Venous

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Venous anomalies as potentially lethal risk factors during ordinary catheterization

Veins and Lymphatics ◽

10.4081/vl.2015.5098 ◽

2015 ◽

Vol 4 (2) ◽

Author(s):

Savino Occhionorelli ◽

Sergio Gianesini ◽

Lorenzo Marinelli ◽

Marianna Daniele ◽

Sara Chierici ◽

...

Keyword(s):

Risk Factors ◽

Risk Factor ◽

Central Venous Catheter ◽

Literature Review ◽

Venous Catheter ◽

Clinical Implications ◽

Venous Malformations ◽

Central Venous ◽

Venous Anomalies ◽

Technology Advancement

Venous malformations are rare but possible findings too, constituting a further risk factor for central venous catheter procedures. Herein we describe a case of death because of an innominate vein perforation by a catheter that incidentally was tucked into a sacciform malformation. Even if the technology advancement is constantly offering us new investigation tools, up to now diagnostic options are limited in the detection of those malformations that could potentially lead to dramatic complications as the described one. The present work raises the awareness about rare venous anomalies and their potential clinical implications. A proper literature review and diagnostic implementation proposal are reported.

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Risk Factors of Central Venous Catheter Leakage in Neonatal Intensive Care Unit

Perinatology ◽

10.14734/pn.2019.30.2.60 ◽

2019 ◽

Vol 30 (2) ◽

pp. 60 ◽

Cited By ~ 1

Author(s):

Young Duck Kim ◽

Na Mi Lee ◽

Su Yeong Kim ◽

Dae Yong Yi ◽

Sin Weon Yun ◽

...

Keyword(s):

Risk Factors ◽

Intensive Care Unit ◽

Intensive Care ◽

Central Venous Catheter ◽

Neonatal Intensive Care Unit ◽

Neonatal Intensive Care ◽

Venous Catheter ◽

Central Venous

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The Risk Factors for Development of Sepsis in Newborns with a Central Venous Catheter and their Association with the Serum Zinc Levels

JOURNAL FOR CLINICAL AND DIAGNOSTIC RESEARCH ◽

10.7860/jcdr/2019/38387.12536 ◽

2019 ◽

Author(s):

Lakshmi Jagath Kumar ◽

Soundarya Mahalingam ◽

Rukmini Mysore Srikantiah ◽

Ali Kumble ◽

Basavaprabhu Achappa

Keyword(s):

Risk Factors ◽

Central Venous Catheter ◽

Serum Zinc ◽

Venous Catheter ◽

Central Venous ◽

Zinc Levels ◽

Serum Zinc Levels

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Central Venous Catheter Salvage in Ambulatory Central Line–Associated Bloodstream Infections

PEDIATRICS ◽

10.1542/peds.2020-042069 ◽

2021 ◽

Author(s):

William J.H. Ford ◽

David G. Bundy ◽

Suzette Oyeku ◽

Moonseong Heo ◽

Lisa Saiman ◽

...

Keyword(s):

Risk Factors ◽

Pediatric Patients ◽

Secondary Analysis ◽

Bloodstream Infections ◽

Venous Catheter ◽

Central Line ◽

Type Number ◽

Central Venous ◽

Medical Centers ◽

Associated Risk Factors

BACKGROUND Guidelines for treatment of central line–associated bloodstream infection (CLABSI) recommend removing central venous catheters (CVCs) in many cases. Clinicians must balance these recommendations with the difficulty of obtaining alternate access and subjecting patients to additional procedures. In this study, we evaluated CVC salvage in pediatric patients with ambulatory CLABSI and associated risk factors for treatment failure. METHODS This study was a secondary analysis of 466 ambulatory CLABSIs in patients <22 years old who presented to 5 pediatric medical centers from 2010 to 2015. We defined attempted CVC salvage as a CVC left in place ≥3 days after a positive blood culture result. Salvage failure was removal of the CVC ≥3 days after CLABSI. Successful salvage was treatment of CLABSI without removal of the CVC. Bivariate and multivariable logistic regression analyses were used to test associations between risk factors and attempted and successful salvage. RESULTS A total of 460 ambulatory CLABSIs were included in our analysis. CVC salvage was attempted in 379 (82.3%) cases. Underlying diagnosis, CVC type, number of lumens, and absence of candidemia were associated with attempted salvage. Salvage was successful in 287 (75.7%) attempted cases. Underlying diagnosis, CVC type, number of lumens, and absence of candidemia were associated with successful salvage. In patients with malignancy, neutropenia within 30 days before CLABSI was significantly associated with both attempted salvage and successful salvage. CONCLUSIONS CVC salvage was often attempted and was frequently successful in ambulatory pediatric patients presenting with CLABSI.

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CE Article: Central Venous Catheter Infection in Canadian Home Parenteral Nutrition Patients: A 5-Year Multicenter Retrospective Study

Journal of the Association for Vascular Access ◽

10.2309/j.java.2020.001.006 ◽

2020 ◽

Vol 25 (1) ◽

pp. 16-26

Author(s):

Olivia Saqui ◽

G. Fernandes ◽

J. Allard

Keyword(s):

Health Care ◽

Retrospective Study ◽

Patient Education ◽

Central Venous Catheter ◽

Parenteral Nutrition ◽

Venous Catheter ◽

Infection Rates ◽

Central Venous ◽

Central Venous Catheter Infection ◽

Significant Health

Highlights A lower CVC infection rate suggests an improvement in practice and education. CVC infection remains a complication that often requires significant health care resources. Use of tunneled CVC and patient education on catheter care reduces CVC infection rates.

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