Complications associated with central venous catheters inserted in critically ill neonates.
Infect Control Hosp Epidemiol
; 12(9): 544-8, 1991 Sep.
Article
en En
| MEDLINE
| ID: mdl-1940277
OBJECTIVE: To assess the incidence and spectrum of complications associated with central venous catheter (CVC) placement in the critically ill infant. DESIGN: A prospective study of all babies hospitalized in a neonatal intensive care unit (NICU) from January 1989 to December 1989. Potential risk factors associated with infection were evaluated by a case-control comparison. SETTING: Conducted at a university-affiliated, tertiary care community hospital. PATIENTS: Neonates requiring intensive care and a central venous catheter. Controls consisted of noninfected babies. RESULTS: Of 263 critically ill neonates, only 13 (4.9%) required a CVC insertion. Seventeen CVCs were placed in these 13 neonates for a total duration of 600 days (median, 32 days/cannula). Fifteen (88%) of these cannulas had one or more complications during its catheter life including dislodgement or leakage (53%), occlusion or thrombosis (47%), infections (29%), or minor bleeding (12%). Five babies (29%) developed 6 episodes of bloodstream infection including 3 sporadic cases due to Staphylococcus epidermidis and a cluster of fungemia due to Malassezia furfur associated with lipid emulsion therapy. Infants with a CVC-associated infection were a younger gestational age (24 weeks versus 32 weeks, p = .04) and weighed less at birth (580 g versus 1285 g, p = .02). The overall rate of bloodstream infection was one episode per 100 days of catheter use. CONCLUSIONS: CVCs may be lifesaving to a critically ill neonate, but complications occur frequently. Use must be restricted to infants in whom alternate delivery routes of intravenous therapy or support are otherwise unavailable.
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Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Trombosis
/
Cateterismo Venoso Central
/
Infección Hospitalaria
/
Fungemia
/
Sepsis
Tipo de estudio:
Etiology_studies
/
Incidence_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Female
/
Humans
/
Male
/
Newborn
País/Región como asunto:
America do norte
Idioma:
En
Revista:
Infect Control Hosp Epidemiol
Asunto de la revista:
DOENCAS TRANSMISSIVEIS
/
ENFERMAGEM
/
EPIDEMIOLOGIA
/
HOSPITAIS
Año:
1991
Tipo del documento:
Article
Pais de publicación:
Estados Unidos