Incidence of infectious complications associated with central venous catheters in pediatric population

Rosado, Viviane; Camargos, Paulo Augusto Moreira; Clemente, Wanessa Trindade; Romanelli, Roberta Maia de Castro

doi:10.1016/j.ajic.2012.10.024

Cited by 5 publications

(7 citation statements)

References 18 publications

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“…60 Tunneled-cuffed CVADs and totally implantable venous devices were associated with high rates of infection and thrombosis but were reported as suitable for long-term therapies in this population. 34,73,111,115 No studies or CPGs reported on the suitability of midline devices in this population specifically, although they were more broadly considered appropriate for therapies lasting 1 to 4 weeks. 76…”

Section: Stable Critically Ill Patientsmentioning

confidence: 99%

Selection and Insertion of Vascular Access Devices in Pediatrics: A Systematic Review

et al. 2020

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OBJECTIVE: To critically review the evidence for the selection and insertion of pediatric vascular access devices (VADs). DATA SOURCES: Data were sourced from the US National Library of Medicine, Cumulative Index to Nursing and Allied Health, the Cochrane Library databases, Embase, and international clinical trial databases. STUDY SELECTION: Clinical practice guidelines, systematic reviews, cohort designs, randomized control trials (RCTs), quasi RCTs, before-after trials, or case-control studies that reported on complications and/or risk as well as reliability of VADs in patients aged 0 to 18 years were included. DATA EXTRACTION: Articles were independently reviewed to extract and summarize details on the number of patients and catheters, population, age of participants, VAD type, study method, indication, comparators, and the frequency of VAD failure or complications. RESULTS: VAD selection and insertion decision-making in general hospitalized and some specialized patient populations were well evidenced. The use of single-lumen devices and ultrasound-guided techniques was also broadly supported. There was a lack of RCTs, and for neonates, cardiac patients, patients with difficult venous access, midline catheters, catheter-tovein ratio, and near-infrared devices, the lack of evidence necessitated broadening the review scope. LIMITATIONS: Limitations include the lack of formal assessment of the quality of evidence and the lack of RCTs and systematic reviews. Consequently, clinical decision-making in certain pediatric populations is not guided by strong, evidence-based recommendations. CONCLUSIONS: This is the first synthesis of available evidence for the selection and insertion of VADs in pediatric patients and is important for determining the appropriateness of VADs in pediatric patients. WHAT'S KNOWN ON THIS SUBJECT: Individual studies, systematic reviews, and focused clinical practice guidelines that evaluate vascular access devices (VADs) in various pediatric populations are available. However, to date, no systematic review examining the appropriateness, and inappropriateness, of VADs across common pediatric clinical scenarios exists. WHAT THIS STUDY ADDS: There is strong evidence to support and facilitate appropriate clinical decision-making in some pediatric indications. However, certain populations, device types and characteristics, and insertion procedures are poorly evidenced, necessitating the application of clinical judgment for VAD decision-making.

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Section: Stable Critically Ill Patientsmentioning

confidence: 99%

Selection and Insertion of Vascular Access Devices in Pediatrics: A Systematic Review

et al. 2020

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“…Cette forte incidence, en lien avec une particulière susceptibilité de ces patients aux infections, est à moduler en fonction du très faible effectif recruté dans cette unité (4 CVC dont pour 1000 jours-CVC en réanimation néonatale (20). Ces incidences sont plus faibles que celles que nous avons retrouvées (2,4/1000 jours-CVC, IC95% [0,9-5,1] en réanimation pédiatrique et 13,7/1000 jours-CVC, IC95% [9,[6][7][8][9][10][11][12][13][14][15][16][17][18]9] en réanimation néonatale). Les services de réanimations pédiatriques et néonatales au Brésil rapportent une DI comparable à 13,55 pour 1000 jours CVC (7).…”

Section: Discussionunclassified

“…Ces incidences sont plus faibles que celles que nous avons retrouvées (2,4/1000 jours-CVC, IC95% [0,9-5,1] en réanimation pédiatrique et 13,7/1000 jours-CVC, IC95% [9,[6][7][8][9][10][11][12][13][14][15][16][17][18]9] en réanimation néonatale). Les services de réanimations pédiatriques et néonatales au Brésil rapportent une DI comparable à 13,55 pour 1000 jours CVC (7). Les données de 2013 du NHSN de 36 montrent des DI allant de 0,3 à 1,3/1000 en réanimation pédiatrique et de 0,5 à 2,2/1000 en réanimation néonatale (16).…”

Section: Discussionunclassified

“…infections) et un intervalle de confiance très large (IC95%[3;88]. L'incidence des infections liées aux CVC est la plus forte dans le service de réanimation néonatale (13,7/1000 jours-CVC, IC95%[9,[6][7][8][9][10][11][12][13][14][15][16][17][18]9]), notamment en ce qui concerne les CVO (12,3/1000 jours-CVO) (IC95%[5,3-24,2]. Cette densité d'incidence est plus importante que celle retrouvée par le réseau Néocat en 2014 (14) : DI de 4,6/1000 CVO et de 10,4/1000 pour les autres CVC, mais comparable à des données américaines publiées en 2009 une DI de 10 ILCt pour 1000 jours-CVC pour les CVO et les CECC (21).…”

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One year of catheter-related infection in a pediatric university hospital: a prospective study

Marion¹

2016

Preprint

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“…4) 제한점 소아에서 초음파 유도 삽입의 장점이 잘 알려졌고 관련 학회에서 이를 권고하지만, 실제 사용 빈도는 낮은 실정이 다 28,29) . De Souza 등 21 39) . 성인 연구에서는 대퇴정맥 삽입이 쇄골하정맥 삽입보다 감염 발생률이 높 았다 40,41) .…”

Section: 초음파 유도 삽입unclassified

Ultrasound-guided central venous catheter insertion in pediatric patients

Chang¹,

Park²,

Jung³

2020

Pediatr Emerg Med J

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In pediatric patients, central venous catheterization (CVC) is necessary for administration of fluids, drugs, high concentration electrolytes, vasopressors or inotropic drugs, transfusion, intravenous nutrition, and dialysis. Using an anatomical landmark for the CVC insertion may have a low success rate in children due to the positional variation between the deep vein and the landmarks, the small size of body and blood vessels, low insertion frequency, and operator skill. In order to improve the success rate, ultrasound guided CVC insertion is recommended in critically ill children. It is also expected to reduce mechanical complications, which are more common with subclavian CVC insertion. However, the association between the insertion site and the infection or thrombosis is unclear. Since thrombosis is relatively common, further studies are needed on the association between the incidence rate and insertion sites.

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Incidence of infectious complications associated with central venous catheters in pediatric population

Cited by 5 publications

References 18 publications

Selection and Insertion of Vascular Access Devices in Pediatrics: A Systematic Review

Selection and Insertion of Vascular Access Devices in Pediatrics: A Systematic Review

One year of catheter-related infection in a pediatric university hospital: a prospective study

Ultrasound-guided central venous catheter insertion in pediatric patients

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