Use of peripherally inserted central catheters in ICU patients: We need to put in balance the important risks versus the potential advantages!

Honoré, Patrick M.; Redant, Sebastien; Préseau, Thierry; Moorthamers, Sofie; Kaefer, Keitiane; Gutierrez, Leonel Barreto; Attou, Rachid; Gallerani, Andrea; Bels, David De

doi:10.1016/j.jcrc.2021.06.023

Cited by 2 publications

(2 citation statements)

References 5 publications

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“…The transportation safety of critically ill patients has always been a hot topic recently. In 2015, American medical institutions listed “patient transport” as one of the top 10 patient safety issues to be concerned about [ 3 ]. Although the transit time ranges from a few minutes to several hours, it may bring about all kinds of side effects due to the limitations of medical conditions, alterations in the environment, uneven transport and escort personnel, different conditions, and poor stability [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

Multifactor Logistic Analysis to Explore the Risk Factors of Safety Risks in the Transport of Critically Ill Patients with ICU and the Improvement of Nursing Strategies

Zhang

Gong

2022

Computational and Mathematical Methods in Medicine

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Objective. Multivariate logistic analysis was employed to explore the risk factors of safety risks in the transport of critically ill patients with ICU and the improvement of nursing strategies. Methods. Two hundred critical transport patients with ICU treated in our hospital from January 2019 to April 2021 were enrolled. According to the occurrence of unsafe events in transit, the patients were assigned to the control group (165 cases without unsafe events, n = 165 ) and the study group (35 cases with safety incidents, n = 35 ). Multivariate logistic analysis was employed to explore the risk factors of safety risks in the transport of critically ill patients with ICU and to enhance nursing strategies. Results. (1) General data of the subjects: among the 200 critically ill patients with ICU who needed in-hospital transport, the age ranged from 18 to 85 years with an average age of 52.48 ± 3.31 , including 89 males and 111 females. There were 35 cases of gastrointestinal bleeding, 16 cases of respiratory failure, 23 cases of heart failure, 43 cases of myocardial infarction, 26 cases of cerebrovascular accident, 14 cases of ectopic pregnancy, 25 cases of severe injury, and 18 cases of mechanical ventilation. There were 35 cases in the study group with accidents and 45 cases in group B without accidents. (2) Among the 200 patients, 35 patients had complications during the transit process in the intermediate people’s court, with an incidence rate of 17.5%. It included blood pressure fluctuation ( n = 6 ), artificial airway obstruction ( n = 6 ), decrease in blood oxygen saturation ( n = 10 ), dyspnea ( n = 5 ), fall pain ( n = 3 ), elevated intracranial pressure ( n = 2 ), and other factors ( n = 3 ). There exhibited no significant difference in blood oxygen saturation at each time point during transport ( P > 0.05 ). There exhibited no significant difference in SpO2 before transport. The comparison of 5 min and 10 min blood oxygen saturation during transit in the study group was lower compared to the control group ( P < 0.05 ). (3) In a univariate analysis of safety risks for critically ill ICU patients, home escorts did not show significant differences in hospital transport for critically ill ICU patients ( P > 0.05 ). There were significant differences in terms of age, patient’s condition, transport escort, auxiliary ventilation, means of transport, uncarried drugs and goods, and carrying pipeline ( P < 0.05 ). The results of multivariate logistic regression analysis indicated that age, patient’s condition, transport escort, auxiliary ventilation, means of transport, uncarried drugs and goods, and carrying pipeline were the risk factors affecting the safe transport of critically ill patients ( P < 0.05 ). Conclusion. Age, patient’s condition, transport escort, auxiliary ventilation, means of transport, uncarried drugs and goods, and carrying pipeline are the independent risk factors that affect the safe transport of emergency or ICU critically ill patients. Therefore, in order to reduce the risk of transshipment, we must enhance the safety awareness of escorts, strengthen the management and training of escorts, promote rules and regulations, and formulate dangerous plans, so as to eliminate the occurrence of unsafe factors.

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Section: Introductionmentioning

confidence: 99%

Multifactor Logistic Analysis to Explore the Risk Factors of Safety Risks in the Transport of Critically Ill Patients with ICU and the Improvement of Nursing Strategies

Zhang

Gong

2022

Computational and Mathematical Methods in Medicine

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“…The presence of obstruction associated with a higher risk, and anticoagulant use conferred protection. Both variables might be subjected to future interventions in order to decrease risk [ 17 , 18 ].…”

Section: Discussionmentioning

confidence: 99%

Risk of deep venous thrombosis associated with peripherally inserted central catheter: A retrospective cohort study of 11.588 catheters in Brazil

Silva,

Braga,

Vieira Junior

2024

PLoS ONE

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Introduction Deep Venous Thrombosis (DVT) due to Peripherally Inserted Central Catheter (PICC) is one of the most threatening complications after device insertion. Objective To assess the rate of PICC-associated DVT and analyze the risk factors associated with this event in cancer and critically ill patients. Methods We conducted a descriptive, retrospective cohort study with 11,588 PICCs from December 2014 to December 2019. Patients ≥ 18 years receiving a PICC were included. Pre-and post-puncture variables were collected and a logistic regression was used to identify the independent factors associated with the risk of DVT. Results The DVT prevalence was 1.8% (n = 213). The median length of PICC use was 15.3 days. The median age was 75 years (18; 107) and 52% were men, 53.5% were critically ill and 29.1% oncological patients. The most common indications for PICC’s were intravenous antibiotics (79.1%). Notably, 91.5% of PICC showed a catheter-to-vein ratio of no more than 33%. The tip location method with intracavitary electrocardiogram was used in 43%. Most catheters (67.9%) were electively removed at the end of intravenous therapy. After adjusting for cancer profile ou chemotherapy, regression anaysis revealed that age (OR 1.011; 95% CI 1.002–1.020), previous DVT (OR 1.96; 95% CI 1.12–3.44) and obstruction of the device (OR 1.60; 95% CI 1.05–2.42) were independent factors associated with PICC-associated DVT, whereas the use of an anticoagulant regimen was a protective variable (OR 0.73; 95% CI 0.54–0.99). Conclusion PICC is a safe and suitable intravenous device for medium and long-term therapy, with low rates of DVT even in a cohort of critically ill and cancer patients.

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Use of peripherally inserted central catheters in ICU patients: We need to put in balance the important risks versus the potential advantages!

Cited by 2 publications

References 5 publications

Multifactor Logistic Analysis to Explore the Risk Factors of Safety Risks in the Transport of Critically Ill Patients with ICU and the Improvement of Nursing Strategies

Multifactor Logistic Analysis to Explore the Risk Factors of Safety Risks in the Transport of Critically Ill Patients with ICU and the Improvement of Nursing Strategies

Risk of deep venous thrombosis associated with peripherally inserted central catheter: A retrospective cohort study of 11.588 catheters in Brazil

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