Journal article
Outcomes associated with peripherally inserted central catheters in hospitalised children: a retrospective 7-year single-centre experience
BMJ open, Vol.9(8), pp.e026031-e026031
08/2019
DOI: 10.1136/bmjopen-2018-026031
PMCID: PMC6707696
PMID: 31444177
Abstract
ObjectivesThe use of peripherally inserted central catheters (PICCs) are an integral part of caring for hospitalised children. We sought to estimate the incidence of and identify the risk factors for complications associated with PICCs in an advanced registered nurse practitioners (ARNP)-driven programme.DesignRetrospective cohort study.SettingSingle-centre, large quaternary children's hospital.ParticipantsHospitalised children who had PICC inserted from 1 January 2010 to 31 December 2016.InterventionsNone.Measurement and main resultsA total of 2558 PICCs were placed during the study period. Mean age at PICC insertion was 8.7 years, mean dwell time was 17.7 days. The majority of PICCs (97.8%) were placed by ARNP. Most were placed in a single attempt (79.6%). Mean PICC residual external length outside was 2.1±2.7 cm. The rate of central line-associated bloodstream infection (CLABSI), thrombosis and significant bleeding were 1.9%, 1% and 0.2%, respectively. The CLABSI rate in infants and early childhood was higher than those aged ≥5 years (2.8%, 3.1%, respectively vs 1.3%). In a multivariate analysis after adjustment of confounding effects of race and gender, infants (OR= 2.24, CI=1.14 to 4.39, p=0.02) and early childhood cohort (OR=2.37, CI=1.12 to 5.01, p=0.02) were associated with significantly higher odds of developing CLABSI compared with ≥5 years old. In the early childhood cohort, PICCs with longer residual external catheter length (OR=1.30, 95% CI=1.07 to 1.57, p=0.008) and those placed in the operating room (OR=5.49, 95% CI=1.03 to 29.19, p=0.04), were associated with significantly greater risk of developing CLABSI.ConclusionsThe majority of PICCs were successfully placed by ARNPs on the first attempt and had a low incidence of complications. Infants required more attempts for successful PICC placement than older children. The presence of residual external catheter length and placement in the operating room were independent predictors of CLABSI in younger children.
Details
- Title: Subtitle
- Outcomes associated with peripherally inserted central catheters in hospitalised children: a retrospective 7-year single-centre experience
- Creators
- Aditya Badheka - University of Iowa Stead Family Children’s HospitalJodi Bloxham - University of IowaApril Schmitz - University of Iowa Stead Family Children’s HospitalBarbara Freyenberger - University of Iowa Stead Family Children’s HospitalTong Wang - University of IowaSankeerth Rampa - Rhode Island CollegeJennifer Turi - Duke Children's Hospital & Health CenterVeerasathpurush Allareddy - University of Illinois at ChicagoMarcelo Auslender - University of IowaVeerajalandhar Allareddy - University of Illinois at Chicago
- Resource Type
- Journal article
- Publication Details
- BMJ open, Vol.9(8), pp.e026031-e026031
- DOI
- 10.1136/bmjopen-2018-026031
- PMID
- 31444177
- PMCID
- PMC6707696
- ISSN
- 2044-6055
- eISSN
- 2044-6055
- Grant note
- name: Research Section of Society of Critical Care Medicine 47th Annual Congress, award: Aditya Badheka, MD, MS was the recipient of a Trav
- Language
- English
- Date published
- 08/2019
- Academic Unit
- Critical Care; Stead Family Department of Pediatrics; Nursing; Business Analytics
- Record Identifier
- 9984353928902771
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