Faculty Opinions recommendation of Central venous catheter repair is associated with an increased risk of bacteremia and central line-associated bloodstream infection in pediatric patients.

2012 ◽  
Author(s):  
Theo Zaoutis
Keyword(s):  
Central Venous Catheter ◽  
Bloodstream Infection ◽  
Pediatric Patients ◽  
Venous Catheter ◽  
Central Line ◽  
Central Venous ◽  
Increased Risk

scholarly journals Estratégia Multidimensional na Redução de Infeção Associada a Cateter Venoso Central em Pediatria

2016 ◽  
Vol 29 (6) ◽  
pp. 373
Author(s):  
Jorge Rodrigues ◽  
Andrea Dias ◽  
Guiomar Oliveira ◽  
José Farela Neves
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Central Venous Catheter ◽  
Bloodstream Infection ◽  
Pediatric Intensive Care Unit ◽  
Pediatric Intensive Care ◽  
Venous Catheter ◽  
Central Line ◽  
Central Venous ◽  
Group 2

<p><strong>Introduction:</strong> To determine the central-line associated bloodstream infection rate after implementation of central venous catheter-care practice bundles and guidelines and to compare it with the previous central-line associated bloodstream infection rate.<br /><strong>Material and Methods:</strong> A prospective, longitudinal, observational descriptive study with an exploratory component was performed in a Pediatric Intensive Care Unit during five months. The universe was composed of every child admitted to Pediatric Intensive Care Unit who inserted a central venous catheter. A comparative study with historical controls was performed to evaluate the result of the intervention (group 1 <em>versus</em> group 2).<br /><strong>Results:</strong> Seventy five children were included, with a median age of 23 months: 22 (29.3%) newborns; 28 (37.3%) with recent surgery and 32 (43.8%) with underlying illness. A total of 105 central venous catheter were inserted, the majority a single central venous catheter (69.3%), with a mean duration of 6.8 ± 6.7 days. The most common type of central venous catheter was the short-term, non-tunneled central venous catheter (45.7%), while the subclavian and brachial flexure veins were the most frequent insertion sites (both 25.7%). There were no cases of central-line associated bloodstream infection reported during this study. Comparing with historical controls (group 1), both groups were similar regarding age, gender, department of origin and place of central venous catheter insertion. In the current study (group 2), the median length of stay was higher, while the mean duration of central venous catheter (excluding peripherally inserted central line) was similar in both groups. There were no statistical differences regarding central venous catheter caliber and number of lumens. Fewer children admitted to Pediatric Intensive Care Unit had central venous catheter inserted in group 2, with no significant difference between single or multiple central venous catheter.<br /><strong>Discussion:</strong> After multidimensional strategy implementation there was no reported central-line associated bloodstream infection<br /><strong>Conclusions:</strong> Efforts must be made to preserve the same degree of multidimensional prevention, in order to confirm the effective reduction of the central-line associated bloodstream infection rate and to allow its maintenance.</p>

scholarly journals Association of Immediate Reinsertion of New Catheters With Subsequent Mortality Among Patients With Suspected Catheter Infection: a Cohort Study

2021 ◽  
Author(s):  
Yiyue Zhong ◽  
Liehua Deng ◽  
Limin Zhou ◽  
Shaoling Liao ◽  
Liqun Yue ◽  
...  
Keyword(s):  
Propensity Score ◽  
Central Venous Catheter ◽  
Bloodstream Infection ◽  
Venous Catheter ◽  
Cox Proportional Hazards ◽  
University Hospital ◽  
Matched Cohort ◽  
Central Venous ◽  
Kaplan Meier ◽  
Increased Risk

Abstract BackgroundCentral venous catheter (CVC) insertion complications are a prevalent and significant problem in the intensive care unit (ICU), but optimal strategy for management in patients with suspected catheter-related bloodstream infection (CRBSI) remains unclear. We sought to determine the effect of immediate reinsertion of new catheter (IRINC) on 30-day mortality among patients after central venous catheter (CVC) removal for suspected CRBSI.MethodsWe conducted a propensity-score-matched cohort of suspected CRBSI who underwent IRINC or not in a 32-bed ICU of university hospital in China during the period from January 2009 through April 2021. We used the results of catheter tip culture to identify patients with suspected CRBSI by index for institutional electronic laboratory databases. The inclusion criteria were age ≥ 18 years, CVC and suspected CRBSI. The exclusion criteria were dialysis catheters, peripheral catheterization, length of stay less than 48 hours, and patients with no access to medical records. Kaplan-Meier method was used to analyze 30-day mortality before and after propensity-score-matching, and adjusted hazard ratio (HR) and 95% confidence interval (CI) for mortality in matched cohort were estimated with Cox proportional hazards models.ResultsIn total, 1238 patients with CVC removal due to suspected CRBSI were identified. Among these patients, 877 (70.8%) underwent IRINC, and 361 (29.2%) did not. In 682 propensity score-matched patients, IRINC was associated with an increased risk of 30-day mortality (HR, 1.481; 95% CI, 1.028 to 2.134) after multivariable, multilevel adjustment. Kaplan-Meier analysis found that IRINC showed a similar risk of mortality before matching (P=0.00096) and after matching (P=0.018). The competing risks analysis confirmed the results of the propensity score-matched analysis. The attributable risk for bloodstream infection was not significantly different (HR, 1.081; 95% CI 0.964 to 1.213) but that for pneumonia was significantly different (HR, 1.128; 95% CI 1.031 to 1.233) in patients with suspected CRBSI in terms of 30-day mortality.ConclusionsIRINC during suspected CRBSI was associated with an increased 30-day mortality risk. These data suggest that it is necessary to focus more on other insertion-related complications along with preventing CRBSI in critically ill patients.Trial RegistrationThis study was registered with the China Clinical Trials Registry (ChiCTR1900022175), URL: http://www.chictr.org.cn/index.aspx.

Central venous catheter salvage in children with Staphylococcus aureus central line-associated bloodstream infection

2017 ◽  
Vol 33 (11) ◽  
pp. 1201-1207 ◽  
Author(s):  
Kristine S. Corkum ◽  
Rachel E. Jones ◽  
Caroline H. Reuter ◽  
Larry K. Kociolek ◽  
Elaine Morgan ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Central Venous Catheter ◽  
Bloodstream Infection ◽  
Venous Catheter ◽  
Central Line ◽  
Central Venous

Central venous catheter bundle adherence: Kamishibai card (K-card) rounding for central-line–associated bloodstream infection (CLABSI) prevention

2020 ◽  
Vol 41 (9) ◽  
pp. 1058-1063
Author(s):  
Jennifer A. Ormsby ◽  
Julie Cronin ◽  
Jane Carpenter ◽  
Dionne A. Graham ◽  
Gail Potter-Bynoe ◽  
...  
Keyword(s):  
Central Venous Catheter ◽  
Real Time ◽  
Bloodstream Infection ◽  
Venous Catheter ◽  
Baseline Period ◽  
Central Line ◽  
Central Venous ◽  
Improvement Project ◽  
Core Elements ◽  
Clabsi Rate

AbstractObjective:To institute facility-wide Kamishibai card (K-card) rounding for central venous catheter (CVC) maintenance bundle education and adherence and to evaluate its impact on bundle reliability and central-line–associated bloodstream infection (CLABSI) rates.Design:Quality improvement project.Setting:Inpatient units at a large, academic freestanding children’s hospital.Participants:Data for inpatients with a CVC in place for ≥1 day between November 1, 2017 and October 31, 2018 were included.Intervention:A K-card was developed based on 7 core elements in our CVC maintenance bundle. During monthly audits, auditors used the K-cards to ask bedside nurses standardized questions and to conduct medical record documentation reviews in real time. Adherence to every bundle element was required for the audit to be considered “adherent.” We recorded bundle reliability prospectively, and we compared reliability and CLABSI rates at baseline and 1 year after the intervention.Results:During the study period, 2,321 K-card audits were performed for 1,051 unique patients. Overall maintenance bundle reliability increased significantly from 43% at baseline to 78% at 12 months after implementation (P < .001). The hospital-wide CLABSI rate decreased from 1.35 during the 12-month baseline period to 1.17 during the 12-month intervention period, but the change was not statistically significant (incidence rate ratio [IRR], 0.87; 95% confidence interval [CI], 0.60–1.24; P = .41).Conclusions:Hospital-wide CVC K-card rounding facilitated standardized data collection, discussion of reliability, and real-time feedback to nurses. Maintenance bundle reliability increased after implementation, accompanied by a nonsignificant decrease in the CLABSI rate.

CE Article: A Quality Improvement Approach in Standardizing Pediatric Central Venous Catheter Dressings and Its Impact on the Reduction of Central Line-Associated Bloodstream Infections and Costs

2019 ◽  
Vol 24 (2) ◽  
pp. 11-19
Author(s):  
Christopher Kramer ◽  
Darcy Doellman ◽  
Casey Blaser ◽  
Robin Huneke Rosenberg ◽  
Stéphanie F. Bernatchez
Keyword(s):  
Quality Improvement ◽  
Central Venous Catheter ◽  
Pediatric Patients ◽  
Bloodstream Infections ◽  
Venous Catheter ◽  
Central Line ◽  
Central Venous ◽  
Clabsi Rate

Highlights A CVC dressing inventory is beneficial to pediatric patients. Dressing standardization reduced unplanned dressing changes and costs. In our study, the new dressing inventory helped reduce the CLABSI rate.

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