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Complications Associated with 2 Different Types of Percutaneously Inserted Central Venous Catheters in Very Low Birth Weight Infants

Published online by Cambridge University Press:  02 January 2015

Ming-Horng Tsai
Affiliation:
Division of Neonatology and Pediatric Hematology/Oncology, Department of Pediatrics, Chang Gung Memorial Hospital, Yunlin, Taiwan College of Medicine, Chang Gung University, Taoyuan, Taiwan Chang Gung Institute of Technology, Chiayi, Taiwan
Shih-Ming Chu
Affiliation:
College of Medicine, Chang Gung University, Taoyuan, Taiwan Pediatric Neonatology, Department of Pediatrics, Chang Gung Children's Hospital and Chang Gung Memorial Hospital, Linko, Taoyuan, Taiwan
Reyin Lien
Affiliation:
College of Medicine, Chang Gung University, Taoyuan, Taiwan Pediatric Neonatology, Department of Pediatrics, Chang Gung Children's Hospital and Chang Gung Memorial Hospital, Linko, Taoyuan, Taiwan
Hsuan-Rong Huang
Affiliation:
College of Medicine, Chang Gung University, Taoyuan, Taiwan Pediatric Neonatology, Department of Pediatrics, Chang Gung Children's Hospital and Chang Gung Memorial Hospital, Linko, Taoyuan, Taiwan
Jiunn-Wei Wang
Affiliation:
College of Medicine, Chang Gung University, Taoyuan, Taiwan
Chiao-Ching Chiang
Affiliation:
College of Medicine, Chang Gung University, Taoyuan, Taiwan Pediatric Neonatology, Department of Pediatrics, Chang Gung Children's Hospital and Chang Gung Memorial Hospital, Linko, Taoyuan, Taiwan
Jen-Fu Hsu
Affiliation:
College of Medicine, Chang Gung University, Taoyuan, Taiwan Pediatric Neonatology, Department of Pediatrics, Chang Gung Children's Hospital and Chang Gung Memorial Hospital, Linko, Taoyuan, Taiwan
Yhu-Chering Huang*
Affiliation:
College of Medicine, Chang Gung University, Taoyuan, Taiwan Pediatric Infectious Diseases, Department of Pediatrics, Chang Gung Children's Hospital and Chang Gung Memorial Hospital, Linko, Taoyuan, Taiwan
*
Department of Pediatrics, Chang Gung Memorial Hospital, No. 5, Fu-Shin St., Kweishan, Taoyuan 333, Taiwan (ychuang@adm.cgmh.org.tw)

Abstract

Objective.

To identify the prevalence and risk factors for complications associated with percutaneously inserted central venous catheters (PICCs) and evaluate the effect of different catheter types and their indwelling time on catheter-related complications.

Design.

Retrospective cohort study.

Setting.

A 49-bed neonatal intensive-care teaching hospital in Taiwan.

Patients.

Between 2004 and 2007, 518 single-lumen PICCs (defined as “old type”) and 290 PICCs with a stiffening stylet and a thicker introducer (“new type”) were inserted in a total of 534 neonates with a birth body weight of 1,500 g or less.

Results.

Independent risk factors of catheter-related sepsis (CRS) were longer duration for PICC placement and PICC inserted at femoral site (compared with nonfemoral sites) (odds ratio [OR], 1.53 [95% confidence interval {CI}, 1.07-2.25]; P = .044). An independent predictor of catheter-related noninfectious complications was time spent for PICC insertion of more than 60 minutes (compared with less than 30 minutes) (OR, 1.96 [95% CI, 1.08-3.53]; P = .026). New-type PICCs were significantly associated with a higher rate of femoral site insertion, catheter-related noninfectious complications, and longer time for successful insertion than old-type PICCs. The hazard rates of CRS according to indwelling time, determined over 5-day periods by survival analysis, showed 0.05% for catheters in place for 4 days or less; 0.27% for 5-9 days; 0.40% for 10-14 days; 0.68% for 15-19 days; 1.18% for 20-24 days; 3.96% for 25-29 days; and 10.45% for 30 or more days.

Conclusions.

Different catheters do influence the complication rates. Spending more than 60 minutes for successful PICC insertion and PICCs indwelling for more than 30 days are associated with higher rates of catheter-related complications.

Type
Original Article
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2011

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