Are Peripherally Inserted Central Catheters Associated With Increased Risk of Adverse Events in Status 1B Patients Awaiting Transplantation on Continuous Intravenous Milrinone?

Haglund, Nicholas; Cox, Zachary L.; Lee, Jeff T.; Song, Yanna; Keebler, Mary; DiSalvo, Thomas G.; Maltais, Simon; Lenihan, Daniel J.; Wigger, M.

doi:10.1016/j.cardfail.2014.06.004

Cited by 16 publications

(9 citation statements)

References 34 publications

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“…[22][23][24] In the pre-heart-transplant population specifically, PICCs with >1 lumen are associated with an earlier time to infection. 25 With the complexity of their illness, the pre-heart-transplant population often has other lines in place and demonstrates the need to remove unnecessary catheters. Additionally, findings of this study suggest higher risk of CLABSI with longer duration of individual PAC use, which agrees with prior studies showing a correlation in several different types of intravascular catheters.…”

Section: Discussionmentioning

confidence: 99%

“…26 The economic burden of CLABSI is significant through additional ICU length of stay, total hospital length of stay, and additional therapies. 25,27,28 The limitations of this study include its retrospective nature and inclusion of a single center, allowing for the potential introduction of selection bias. The study is further limited by the small number of CLABSI events, and caution should be taken when drawing conclusions.…”

Section: Discussionmentioning

confidence: 99%

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Pulmonary artery catheter epidemiology of risk in pre–heart-transplant recipients

Yetmar

Lahr

O’Horo

et al. 2019

Infect. Control Hosp. Epidemiol.

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Objective:Central-line–associated bloodstream infections (CLABSIs) are a known complication of central venous access. Pulmonary artery catheters (PAC) are frequently used in pre–heart-transplant patients, but the rate of CLABSI in this population is unknown. We sought to estimate the rate of CLABSI and identify factors associated with development of infection in patients actively listed for heart transplantation with a PAC.Design:Retrospective cohort study.Setting:This study was conducted in 3 intensive care units at an academic tertiary-care center in Minnesota.Patients:61 pre–heart-transplant patients in an intensive care unit with a PAC in place from January 2013 to December 2016, totaling 219 PACs.Methods:At-risk patients, pertinent risk factors, and demographic data were obtained using Mayo Clinic’s Unified Data Platform. CLABSIs were identified through internal infection prevention and control data. Characteristics of PAC use and infection rate were collected and analyzed using Kaplan-Meier estimates and time-dependent Cox models.Results:Among pre–heart-transplant patients with a PAC, there were 14 CLABSIs, for an infection rate of 5.46 of 1,000 PAC days (95% confidence interval [CI], 2.98–9.15). The most common causative organism was coagulase-negative Staphylococcus (79%). In unadjusted analyses, CLABSI was associated with shorter time to transplant (hazard ratio [HR], 2.49; P = .027), but not mortality (HR, 1.79; P = .355).Conclusions:The rate of CLABSI with PAC is high. Prolonged PAC use in the pre–heart-transplant population should be revisited.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Pulmonary artery catheter epidemiology of risk in pre–heart-transplant recipients

Yetmar

Lahr

O’Horo

et al. 2019

Infect. Control Hosp. Epidemiol.

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“…Haglund et al report that at their center in Nashville, Tennessee, patients with anticipated long transplant wait times (eg, large male, blood type O) are referred to LVAD therapy early, whereas patients with anticipated shorter times may be maintained on inotropes. 4 In our center in Cleveland, Ohio, we have seen significantly prolonged transplant waiting times in the past few years. Consequently, we adopted a more aggressive utilization of continuous-flow LVAD therapy versus home inotrope use for transplant candidates.…”

mentioning

confidence: 98%

“…In this edition of the Journal of Cardiac Failure, Haglund et al explore another aspect of inotrope dependency: the implications of having a central venous catheter (CVC). 4 In their single-center retrospective study, these investigators reviewed adverse events (AEs) as related to peripherally inserted CVCs (PICC) in 129 patients with stage D HF supported by intravenous milrinone who were listed as United Network for Organ Sharing status 1B for cardiac transplantation. They found a startlingly high rate of AEs related to PICC use (27% of the population), which was primarily driven by infections.…”

mentioning

confidence: 99%

Implications of Central Venous Catheters in Patients With Stage D Heart Failure Who are Stable but Inotrope Dependent

Gorodeski¹,

Kim²

2014

Journal of Cardiac Failure

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“…Quase um quarto dos PICCs utilizados também era de duplo lúmen, isto porque na presente população é comum o uso de drogas vasoativas e anticoagulantes de forma contínua, pela descompensação clínica da cardiopatia e/ou ponte para transplante cardíaco (76) . Em (77) .…”

Section: Resultsunclassified

Complicações relacionadas ao uso de cateter venoso central semi-implantável não tunelizado em pacientes com afecções cardiopulmonares

Mota¹

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Introduction: Central venous catheterization is characterized by positioning a vascular device whose end reaches the final third of the superior vena cava, regardless of the insertion site. Most patients with cardiopulmonary diseases are elective for its implementation, for presenting a fragile peripheral venous network and need for prolonged infusion solutions. However, this procedure presents invasive character associated with complications. Aim: Analyze the complications related to the use of non-tunneled semi-implantable central venous catheter. Methods: A prospective cohort study (6 months) conducted in intensive care units and medicalsurgical clinics from the Heart Institute of the Medicine Course in University of São Paulo (USP), in adult patients with cardiopulmonary diseases in using peripherally inserted central catheter (PICC) or double lumen catheter (CDL), the daily observation of the catheter until its withdrawal or hospital discharge, associated with access to medical records for information on the patient and the catheter conditions. Study variables related to morbidity and demographics data, catheter insertion, use and maintenance, complications related to the use of catheter, catheter removal. Anlysis: Measures of central tendency and variability, chi-square test or Mann-Whitney test for qualitative data, student's t-test and ANOVA or Kruskal-Wallis test to compare means. Results: There was a predominance of CDL, used in 127 (67.2%) cases, and the PICC in 62 (32.8%). As of the catheters, 55 (43.3%) CDL and 21 (37.0%) PICC had some type of complication. There was a statistical difference (p = 0.017) among the complications according to the types of PICC, being it higher in the open ended ones. There were differences between the complications according to the insertion sites, however, with no statistical difference (p = 0.479). Obstruction occurred in only 3.9% (5) of the CDL, while in PICCs it was present in 11.3% (7) of the cases. The phlebitis grade 1 was present in 23 (18.1%) cases of CDL and 10 (16.1%) cases of PICC. The purulent exudate in the CDL was observed in 9 (7.0%) cases while in PICC was present in only 1 (1.6%) device. The manifestation was present only in the CDL, occurring in 9 (7%) cases. The suspicion of thrombosis was seen in 3 (4.8%) PICC being confirmed in only 1 (1.6%) of them, as well as the rupture present in only 1 (1.6%) PICC. The CDL length of stay was 8.8 (± 6.8) days on average (median 8) ranging from 1 to 38 days. In the case of PICC, it averaged 19.4 (± 21) days (median 14) and ranged 1-141 days. The suspected infection was the majority, being present in CDL in 30 (23.6%) cases and in PICC in 9 (14.5%). In only 1 (2.6%) CDL a bloodstream infection associated with the catheter was confirmed, with tipped catheter and positive blood culture for Chryseobacterium indologenes. Conclusion: The suspected infection was the complication with highest incidence, but confirmed in only one of the cases. There was no statistical difference between the densities of incidence of com...

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Are Peripherally Inserted Central Catheters Associated With Increased Risk of Adverse Events in Status 1B Patients Awaiting Transplantation on Continuous Intravenous Milrinone?

Cited by 16 publications

References 34 publications

Pulmonary artery catheter epidemiology of risk in pre–heart-transplant recipients

Pulmonary artery catheter epidemiology of risk in pre–heart-transplant recipients

Implications of Central Venous Catheters in Patients With Stage D Heart Failure Who are Stable but Inotrope Dependent

Complicações relacionadas ao uso de cateter venoso central semi-implantável não tunelizado em pacientes com afecções cardiopulmonares

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