Peripherally inserted central catheters versus non-tunnelled ultrasound-guided central venous catheters in newborns: a retrospective observational study

Bayoumi, Mohammad A A; Rens, Matheus F. P. T. van; Chandra, Prem; Shaltout, Deena; Gad, Ashraf; Elmalik, Einas Elzubier; Hammoudeh, Samer

doi:10.1136/bmjopen-2021-058866

Cited by 5 publications

(8 citation statements)

References 29 publications

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“…It has been used in many countries including Germany, Italy, and the UK. Despite the overall gradual decrease in the CLABSI rate in our NICU from 12.18 per 1,000 days dwell time in 2010 to 2.14 per 1,000 days dwell time in 2019, this improvement remained unsteady and showed a lack of sustainability ( 21 , 22 , 24 ). In 2016, the antimicrobial-impregnated PICC was introduced to the unit to help in reducing the CLABSI rate aiming for Zero-CLABSI.…”

Section: Discussionmentioning

confidence: 86%

“…The NSN team's roles are the determination of the insertion eligibility criteria, VAD selection, line maintenance ensuring closed system care, blood samples collection, and insertion data entry in the specially designed online data collection system. In our day-to-day practice, there is no difference in the line maintenance quality, personnel, and frequency of all types of CVCs ( 21 , 22 ).…”

Section: Methodsmentioning

confidence: 99%

“…Exceptions are very limited with chronic patients who have difficult vascular access. Preventive removal refers to the unnecessary premature catheter withdrawal before completion of the IV therapy ( 21 , 22 , 24 , 25 ).…”

Section: Methodsmentioning

confidence: 99%

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Does the antimicrobial-impregnated peripherally inserted central catheter decrease the CLABSI rate in neonates? Results from a retrospective cohort study

et al. 2022

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BackgroundThe use of antimicrobial-impregnated peripherally inserted central catheters (PICCs) has been introduced in the last few years to neonatal units aiming to reduce central line-associated bloodstream infection (CLABSI).MethodsThis retrospective observational study aimed to compare the CLABSI rates and other catheter-related parameters including the insertion success rates and catheter-related complications in the antimicrobial-impregnated and conventional (ordinary) PICCs in NICU between 2017 and 2020.ResultsOur dedicated PICC team including physicians and nurses inserted 1,242 conventional (PremiCath and NutriLine) and 791 antimicrobial-impregnated PICCs (PremiStar) over the study period from 2017 to 2020. Of those 1,242 conventional PICCs, 1,171 (94.3%) were 1 Fr single lumen and only 71 (5.7%) were 2 Fr double lumen. The mean ± SD [median (IQR)] for the birth weight in all babies who had a PICC line was 1,343.3 ± 686.75 [1,200 (900, 1,500)] g, while the mean ± SD for the gestational age was 29.6 ± 4.03 [29 (27, 31)] weeks. The mean ± SD [median (IQR)] age at the time of insertion for all catheters was 9.3 ± 21.47 [2 (1, 9)] days, while the mean ± SD [median (IQR)] dwell time was 15.7 ± 14.03 [12 (8, 17)] days. The overall success rate of the PICC insertion is 1,815/2,033 (89.3%), while the first attempt success rate is 1,290/2,033 (63.5%). The mean ± SD [median (IQR)] gestational age, birth weight, age at catheter insertion, and catheter dwell time were 28.8 ± 3.24 [29, (26, 31)] weeks, 1,192.1 ± 410.3 [1,150, (900, 1,450)] g, 6.3 ± 10.85 [2, (1, 8)] days, and 17.73 ± 17.532 [13, (9, 18)] days in the antimicrobial-impregnated catheter compared with 30.1 ± 4.39 [29, (27, 32)] weeks (P < 0.001), 1,439.5 ± 800.8 [1,240, (920, 1,520)] g (P < 0.001), 11.1 ± 25.9 [1, (1, 9)] days (P < 0.001), and 14.30 ± 10.964 [12, (8, 17)] days (P < 0.001), respectively, in the conventional PICCs. The use of the antimicrobial-impregnated catheter was not associated with any significant reduction in the CLABSI rate (per 1,000 days dwell time), either the overall [P = 0.11, risk ratio (RR) (95% CI): 0.60 (0.32, 1.13)] or the yearly CLABSI rates.ConclusionsThe use of miconazole and rifampicin-impregnated PICCs did not reduce the CLABSI rate in neonates compared with conventional PICCs. However, it has a higher overall rate of elective removal after completion of therapy and less extravasation/infiltration, occlusion, and phlebitis compared with the conventional PICCs. Further large RCTs are recommended to enrich the current paucity of evidence and to reduce the risk of bias. Neonatal PICCs impregnation by other antimicrobials is a recommendation for vascular access device manufacturers.

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Section: Discussionmentioning

confidence: 86%

Section: Methodsmentioning

confidence: 99%

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Does the antimicrobial-impregnated peripherally inserted central catheter decrease the CLABSI rate in neonates? Results from a retrospective cohort study

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“…Venipuncture, blade dilation, etc. are needed during catheter placement, and these PICC operations can cause local tissue damage as well as pain to the patients [ 28 ]. With the continuous development of pain specialty, pain has become the fifth vital sign after the four vital signs of breathing, pulse, blood pressure, and body temperature [ 29 ].…”

Section: Discussionmentioning

confidence: 99%

Therapeutic Effect of Ultrasound-Guided Peripherally Inserted Central Catheter Combined with Predictive Nursing in Patients with Large-Area Severe Burns

Zhang

2022

Computational and Mathematical Methods in Medicine

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This study was aimed to explore the application value of ultrasound-guided peripherally inserted central catheter (PICC) combined with predictive nursing in the treatment of large-area severe burns. 88 patients with large-area severe burns who visited hospital were chosen as the research objects. They were randomly divided into the observation group and the control group, with 44 cases in each. The patients in the observation group were treated with ultrasound-guided PICC combined with predictive nursing, while those in the control group were treated with traditional PICC and nursing methods. Then, the anxiety of patients was compared between groups by the Self-rating Anxiety Scale (SAS), while the depression was compared by the Self-rating Depression Scale (SDS). The pain of the patients was analyzed by the McGill Pain Questionnaire (MPQ), and a self-made nursing satisfaction questionnaire was adopted to evaluate the nursing satisfaction. The surgery-related indicators of the patients were detected and recorded (the success rate of one-time puncture, the success rate of one-time catheter placement, incidence of complications, heart rate, blood pressure, etc.). The success rates of one-time puncture (93% vs. 86%) and of catheter placement (95% vs. 81%) in the observation group were significantly higher than those in the control group, P < 0.05 . The pain scores of the observation group were much lower than those of the control group at each time period, P < 0.05 . The number of patients with negative emotions such as anxiety and depression in the observation group was markedly less than that in the control group. The incidence of complications in the observation group was notably lower than that in the control group (4.5% vs 18%), P < 0.05 . The nursing satisfaction of the observation group was significantly higher than that of the control group (93% vs 79.5%), P < 0.05 . In conclusion, ultrasound-guided PICC and predictive nursing had high clinical application values in the treatment of patients with large-area severe burns.

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“…Central lines are typically divided into non-tunnelled (centrally or peripherally inserted), tunnelled and totally implanted [5]. The latter two are of limited use in the neonatal setting [6]. Depending on the policy of each particular unit, the first central line of choice immediately after birth is an umbilical venous catheter (UVC), sometimes alongside an umbilical arterial catheter (UAC).…”

Section: Central Line Typesmentioning

confidence: 99%

Central Lines and Their Complications in Neonates: A Case Report and Literature Review

Perme

2023

Children

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Central lines are essential devices in NICUs, used primarily in preterm neonates and critically ill term neonates. They are typically divided into non-tunnelled, tunnelled and totally implanted. In light of the increasing use of central lines in the NICU setting, monitoring of the risk factors associated with complications has to be an important part of neonatal care quality management. Presented here is a case of a preterm neonate with cardiac tamponade caused by UVC tip migration. Among complications of central lines are CLABSI, with an incidence of 3 to 21 per 1000 catheter days, and portal vein thrombosis, which is common but probably under-recognised, whereas other mechanical complications such as pericardial and pleural effusions are rare, with an incidence of less than 1%. Complications can cause injury to the neonates, as well as increase the costs of health services because of increases in the length of stay in the NICU. It is recommended that the catheter tip location is confirmed either by X-ray or ultrasonography. In order to minimise the risk of CLABSI, the use of bundles is recommended. Certain recommendations need to be followed when using different types of catheters. Future research is aimed at novel ways of central line securement to minimise mechanical complications and the use of antimicrobial catheters to reduce the rate of CLABSI.

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Peripherally inserted central catheters versus non-tunnelled ultrasound-guided central venous catheters in newborns: a retrospective observational study

Cited by 5 publications

References 29 publications

Does the antimicrobial-impregnated peripherally inserted central catheter decrease the CLABSI rate in neonates? Results from a retrospective cohort study

Does the antimicrobial-impregnated peripherally inserted central catheter decrease the CLABSI rate in neonates? Results from a retrospective cohort study

Therapeutic Effect of Ultrasound-Guided Peripherally Inserted Central Catheter Combined with Predictive Nursing in Patients with Large-Area Severe Burns

Central Lines and Their Complications in Neonates: A Case Report and Literature Review

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