Impact of subcutaneous tunnels on peripherally inserted catheter placement: a multicenter retrospective study View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2019-05

AUTHORS

Il Jung Kim, Dong Jae Shim, Jae Hwan Lee, Eung Tae Kim, Jong Hyun Byeon, Hun Jae Lee, Soon Gu Cho

ABSTRACT

OBJECTIVE: To evaluate the impact of subcutaneous tunneling on peripherally inserted central catheter (PICC) placement in terms of central line-associated bloodstream infections (CLABSIs). METHODS: Our dual-facility central institutional review board approved this retrospective study. We compared 302 of 327 consecutive recipients (mean age [± SD], 68.0 ± 15.9 years; men, 134; women, 168) of tunneled PICCs (October 2017 to May 2018) with 309 of 328 consecutive recipients (mean age, 68.7 ± 14.6 years; men, 142; women, 167) of conventional PICCs (April 2016 to September 2017). Tunnels were made near puncture sites (~ 1 in. away) using hemostats or puncture needles. In each group, procedure times and rates of complications, including CLABSI, entry-site infection, dislocation, thrombophlebitis, and occlusion, were examined. Risk factors for CLABSI were analyzed via logistic and Cox regression models. RESULTS: Subcutaneous tunnels were achieved in all patients, enabling successful peripheral vein cannulations. Group procedure times were similar (p = 0.414). CLABSI proved to be significantly less frequent after tunneling (8/6972 catheter-days) than after conventional (28/7574 catheter-days) PICC placement (adjusted hazard ratio = 0.328; 95% confidence interval, 0.149-0.721). Other risk factors (i.e., age, gender, comorbidity, PICC duration, veins, hospital stay, and intensive care unit stay) showed no significant correlations with CLABSI. CONCLUSIONS: Compared with conventional means, a subcutaneous tunneling approach for PICC placement significantly reduces the rate of CLABSI. KEY POINTS: • Subcutaneous tunnels created to place peripherally inserted central catheters significantly reduced catheter-associated bloodstream infections. • Subcutaneous tunnel creation did not significantly prolong procedural time. • There were no subcutaneous tunnel-related complications. More... »

PAGES

2716-2723

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00330-018-5917-x

DOI

http://dx.doi.org/10.1007/s00330-018-5917-x

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1110712352

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/30560363


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