Catheter replacement in continuous arteriovenous hemodiafiltration: The balance between infectious and mechanical complications*

Wester, J. P. J.; Koning, Eelco J.P. de; Geers, A. B. M.; Vincent, H. H.; Jongh, B. M. De; Tersmette, M.; Leusink, J.A.

doi:10.1097/00003246-200206000-00017

Cited by 16 publications

(9 citation statements)

References 16 publications

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“…The higher mortality in this population may compete with catheterrelated bloodstream infection. In agreement with previous reports (17,19), the most frequently cultured microorganism was Staphylococcus epidermidis. Predominance of fungi may be, in part explained by greater broad-spectrum, predominantly antibacterial, antibiotic use in CRRT patients than IHD, as suggested by greater antimicrobial use noted in the Table 1.…”

Section: Discussionsupporting

confidence: 93%

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Continuous Renal Replacement Therapy May Increase the Risk of Catheter Infection

Parienti

Dugué

Daurel³

et al. 2010

Clinical Journal of the American Society of Nephrology

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Background and objectives:Little is known about the risks of catheter-related infections in patients undergoing intermittent hemodialysis (IHD) as compared with continuous renal replacement therapy (CRRT) techniques. We compared the two modalities among critically ill adults requiring acute renal replacement therapy (RRT).Design, setting, participants, & measurements: We used the multicenter Cathedia study cohort of 736 critically ill adults requiring RRT. Cox marginal structural models were used to compare time to catheter-tip colonization at removal (intent-totreat, primary endpoint) among patients who started IHD (n ‫؍‬ 470) versus CRRT (n ‫؍‬ 266). On-treatment analysis was also conducted to take into account changes in prescription of RRT modality.Results: Hazard rate of catheter-tip colonization did not increase within the first 10 days of catheter use. Predictors of catheter-tip colonization were higher lactate levels and hypertension, while systemic antibiotics, antiseptics-impregnated catheters, and mechanical ventilation were associated with decreased risk. The incidence of catheter-tip colonization per 1000 catheter-days was 42.7 in the IHD group and 27.7 in the CRRT group (P < 0.01). This association was no longer significant after correction for channeling bias (weighted HR, 0.96; 95% CI: 0.77 to 1.20, P ‫؍‬ 0.73). On-treatment analysis revealed an increased risk of primary endpoint during CRRT exposure as compared with IHD exposure (weighted HR, 0.71; 95% CI: 0.56 to 0.92, P < 0.009).Conclusions: Our results do not support the use of CRRT when IHD could be an alternative to reduce the risk of catheter-related infection.

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Section: Discussionsupporting

confidence: 93%

“…Based on our results and the results of others (19,30), we recommend against this practice for critical patients admitted in intensive care units who still require acute vascular access for IHD. However, the CRRT group demonstrated an increased risk after 10 days.…”

Section: Discussionmentioning

confidence: 71%

Continuous Renal Replacement Therapy May Increase the Risk of Catheter Infection

Parienti

Dugué

Daurel³

et al. 2010

Clinical Journal of the American Society of Nephrology

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“…The catheterization duration (7 days) reported in this study was similar to those reported in previous studies (5,8,(15)(16)(17)(18), ranging from 4.2 days (16) to 12.0 days (5). This short-term indwelling duration suggests that the extraluminal route of cathetertip colonization predominated (19).…”

Section: Discussionsupporting

confidence: 88%

Quasi-Experimental Study of Sodium Citrate Locks and the Risk of Acute Hemodialysis Catheter Infection among Critically Ill Patients

Parienti

Deryckere

Mégarbane

et al. 2014

Antimicrob Agents Chemother

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“…As for ICU patients, the incidence rates of catheter colonization and catheter-related bloodstream infection have been reported to be 8-31/1,000 catheter days [12] and 1.5-19/1,000 catheter days [13][14][15][16], respectively. Actually, however, reports on hemodialysis catheter-related infections in ICU patients are still limited [16,17]. One such report identified no significant difference in the incidence rates of catheter colonization and catheter-related bloodstream infection between hemodialysis and central venous catheters [16].…”

Section: Discussionmentioning

confidence: 99%

Catheter-Related Infections in Continuous Hemodiafiltration in Intensive Care Patients

Nakada

Hirasawa²,

Oda³

et al. 2004

Blood Purif

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Background/Aims: Infection control is of key importance especially in the application of long-term continuous hemodiafiltration (CHDF) involving invasive vascular catheterization to critically ill patients. We investigated hemodialysis catheter-related infections in long-term CHDF. Methods: We examined catheter infections in 54 patients who were admitted to the intensive care unit and underwent CHDF for 2 weeks or longer. Results: With a total of 155 catheters (1,071 catheter days) studied, catheter colonization and catheter-related bloodstream infection were noted with an incidence rate of 4.8 and 2.7 per 1,000 catheter days, respectively. No difference in catheter colonization rate was observed depending on the catheterization sites or duration of catheterization. Infections were identified in 39 patients (72%) and blood culture positivity was noted in 25 patients (46%). Conclusions: Since the majority of cases requiring long-term CHDF are complicated with a variety of infections, it is difficult to control infections associated with hemodialysis catheters separately from infections of other types. Systemic infection control should serve as a strategy finally leading to successful control of catheter-related infection.

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Catheter replacement in continuous arteriovenous hemodiafiltration: The balance between infectious and mechanical complications*

Cited by 16 publications

References 16 publications

Continuous Renal Replacement Therapy May Increase the Risk of Catheter Infection

Continuous Renal Replacement Therapy May Increase the Risk of Catheter Infection

Quasi-Experimental Study of Sodium Citrate Locks and the Risk of Acute Hemodialysis Catheter Infection among Critically Ill Patients

Catheter-Related Infections in Continuous Hemodiafiltration in Intensive Care Patients

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