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cvc children

Chelsea Balian, Michelle Garcia, Jessica Ward
BACKGROUND: Bloodstream infections (BSIs) are a leading cause of morbidity and mortality in children undergoing hematopoietic stem cell transplant (HSCT). Indwelling central venous catheters (CVCs) increase risk for BSIs, yet mucosal barrier injury-associated laboratory-confirmed bloodstream infection (MBI-LCBI) may also occur due to translocation of pathogenic organisms from the gastrointestinal tract into the bloodstream. The purpose of this study was to determine the association between stool organisms and BSIs in children with CVCs who underwent HSCT...
March 1, 2018: Journal of Pediatric Oncology Nursing: Official Journal of the Association of Pediatric Oncology Nurses
Ana M Lenz, Elena Andion, Silvina Ruvinsky, Clarisa Aguirre, Julieta Alvarez Parma, Facundo Jorro, Gabriela López Cruz, Martín Pascutto, Matías Penazzi, Silvia Santos, Marcela Zuázaga, Norma Aquino, Juan C Vassallo, Guillermo Moreno, Ricardo Magliola, Aldo Haimovich, Luis Landry, Rosa Bologna
INTRODUCTION: Catheter-related infections (CRIs) cause a high level of morbidity and mortality with the increasing use of hospital resources. OBJECTIVE: To describe the outcomes of a program implemented to reduce the rate of CRIs in pediatric intensive care units in Argentina. POPULATION AND METHODS: Collaborative, multi center, clinical-epidemiological, quasiexperimental, before-and-after intervention study. Children who had a central venous catheter during hospitalization in 9 pediatric intensive care units in the Autonomous City of Buenos Aires, Greater Buenos Aires, and other provinces between June 2011 and April 2012 were included...
April 1, 2018: Archivos Argentinos de Pediatría
Emily N Israel, Christopher A Thomas, Christopher W Mastropietro
BACKGROUND: Enoxaparin may be used to prevent central venous catheter-related thrombosis in patients with CHD. We aimed to determine whether current enoxaparin dosing regimens effectively achieve anti-factor Xa concentrations within prophylactic goal ranges in this patient population. METHODS: We implemented a formal protocol aimed at reducing central venous catheter-related thrombosis in children with CHD in January, 2016. Standard empiric prophylactic enoxaparin dosing regimens were used - for example, 0...
March 1, 2018: Cardiology in the Young
Iris Nora Tiraboschi, Natalia Cintia Pozzi, Luciana Farías, Susana García, Norma Beatriz Fernández
BACKGROUND: The epidemiology of candidemia vary by region. AIM: To determine the epidemiology of candidemia in a hospital for 16 years. MATERIAL AND METHODS: Episodes of candidemia occurred in the Hospital de Clinicas of Buenos Aires were reviewed, from 01/01/98 to 31/12/13. RESULTS: 374 episodes of candidemia were identified. The incidence was 2.21/1,000 discharges and increased from 1.96 (1998-2005) to 2.25 (2006-2013) (p = 0...
October 2017: Revista Chilena de Infectología: órgano Oficial de la Sociedad Chilena de Infectología
Royanne L Lichliter, Lynea E Tremewan, Nicole M Shonka, Jennifer E Mehnert, Laney Brennan, Jodi M Thrasher, Teri L Hernandez
Repeated venipunctures and fingersticks to confirm serum drug concentrations cause pain and dissatisfaction for pediatric patients and their families. In many organizations, the standard of care to obtain therapeutic serum drug concentrations by peripheral venipuncture or capillary fingerstick, even when the patient has an existing peripheral intravenous catheter (PIV) or central venous catheter (CVC). The primary objective of this study was to assess agreement between serum tobramycin/vancomycin concentrations collected from a CVC or PIV, versus venipuncture or fingerstick...
February 20, 2018: Journal for Specialists in Pediatric Nursing: JSPN
Iva Hojsak, Valentina Fabiano, Tudor Lucian Pop, Olivier Goulet, Gian Vincenzo Zuccotti, Fugen Cullu Çokuğraş, Massimo Pettoello-Mantovani, Sanja Kolaček
AIM: The use of probiotics has been covered by many guidelines, position papers and evidence-based recommendations, but few have referred to specific patient groups or clinical indications. This European study summarises recommendations and scientifically credited guidelines on the use of probiotics for children and provides practice points. METHODS: An expert panel was convened by the European Paediatric Association in June 2017 to define the relevant clinical questions for using probiotics in paediatric healthcare and review and summarise the guidelines, recommendations, position papers and high-quality evidence...
February 15, 2018: Acta Paediatrica
Alex Chau, Jose Alberto Hernandez, Sheena Pimpalwar, Daniel Ashton, Kamlesh Kukreja
BACKGROUND: Femoral tunneled central line placement in the pediatric population offers an alternative means for intravenous (IV) access, but there is concern for higher complication and infection rates when placed at bedside. OBJECTIVE: To describe the complications and infection outcomes of primary femoral tunneled central venous catheter placement in the interventional radiology suite compared to the portable bedside location at a single tertiary pediatric institution...
February 8, 2018: Pediatric Radiology
Maziar M Nourian, Angelina L Schwartz, Austin Stevens, Eric R Scaife, Brian T Bucher
BACKGROUND: The optimal time to reinsert central venous catheters (tCVC) after a documented central line associated blood stream infection (CLABSI) is unclear. The goal of this study is to identify risk factors for children who develop persistent bacteremia after tCVC removal due to CLABSI. METHODS: We performed a retrospective cohort study from a tertiary children's hospital. Children who underwent removal of a tCVC due to CLABSI were included in our analysis. Our primary outcome was persistent bacteremia after tCVC removal defined by a persistently positive blood culture...
December 24, 2017: Journal of Pediatric Surgery
Brooke T Lawson, Ian A Zealley
PURPOSE: Central venous access in children, in particular small children and infants, is challenging. We have developed a technique employing adult peripherally inserted central venous catheters (PICCs) as tunnelled central venous catheters (TCVCs) in children. The principal advantage of this novel technique is that the removal technique is less complex than that of conventional cuffed TCVCs. The catheter can be removed simply by being pulled out and does not require general anaesthesia...
January 17, 2018: Cardiovascular and Interventional Radiology
Flora Habas, Julien Baleine, Christophe Milési, Clémentine Combes, Marie-Noëlle Didelot, Sara Romano-Bertrand, Delphine Grau, Sylvie Parer, Catherine Baud, Gilles Cambonie
Placement of a central venous catheter (CVC) in the brachiocephalic vein (BCV) via the ultrasound (US)-guided supraclavicular approach was recently described in children. We aimed to determine the CVC maintenance-related complications at this site compared to the others (i.e., the femoral, the subclavian, and the jugular). We performed a retrospective data collection of prospectively registered data on CVC in young children hospitalized in a pediatric intensive care unit (PICU) during a 4-year period (May 2011 to May 2015)...
March 2018: European Journal of Pediatrics
Jeffrey A Alten, Akm Fazlur Rahman, Hayden J Zaccagni, Andrew Shin, David S Cooper, Joshua J Blinder, Lauren Retzloff, Inmaculada B Aban, Eric M Graham, Jeffrey Zampi, Yuliya Domnina, Michael G Gaies
BACKGROUND: Health-care associated infections (HAI) represent serious complications for patients within pediatric cardiac intensive care units (CICU). HAI are associated with increased morbidity, mortality, and resource utilization. There are few studies describing the epidemiology of HAI across the entire spectrum of patients (surgical and non-surgical) receiving care in dedicated pediatric CICUs. METHODS: Retrospective analyses of 22,839 CICU encounters from 10/2013-9/2016 across 22 North American CICUs contributing data to the Pediatric Cardiac Critical Care Consortium clinical registry...
December 26, 2017: Pediatric Infectious Disease Journal
Barbie Drews, Michelle Macaluso, Hannah Piper, Nandini Channabasappa
Pediatric patients with intestinal failure often require central venous catheters for extended periods of time for parenteral nutrition, blood sampling, and medication administration, increasing morbidity, mortality, and costs. In 2007, we reported a central line-associated bloodstream infection rate of 7.0 per 1,000 catheter line-days in our pediatric patients with intestinal failure. On the basis of this high rate of catheter-associated infections, we developed and implemented a central line care curriculum for patients/family caregivers and home health nurses...
November 2017: Gastroenterology Nursing: the Official Journal of the Society of Gastroenterology Nurses and Associates
Minh Tran, Steven L Shein, Xinge Ji, Sanjay P Ahuja
BACKGROUND: The incidence of venous thromboembolism (VTE) is rising among inpatients in US hospitals, especially among kids with central venous catheters (CVCs) in the pediatric intensive care unit (PICU). OBJECTIVES: To identify a sub-group of "VTE-rich" population among PICU children, and to assess the effect of VTE on morbidity and mortality. METHODS: Data was extracted from a multicenter Virtual PICU Database, or VPS, for children with a CVC and presence of a VTE...
January 2018: Thrombosis Research
Julie Jaffray, Arash Mahajerin, Guy Young, Neil Goldenberg, Lingyun Ji, Richard Sposto, Amy Stillings, Emily Krava, Brian Branchford
BACKGROUND: Pediatric hospital-acquired venous thromboembolism (HA-VTE) rates have increased dramatically. To achieve generalizable knowledge in the derivation and validation of HA-VTE risk factors and risk prediction models and inform future risk-stratified prevention strategies, multi-institutional studies are needed. OBJECTIVES: This paper presents an investigator-initiated, multicenter pediatric case-cohort study designed to identify risk factors for HA-VTE to create a HA-VTE risk prediction model...
January 2018: Thrombosis Research
Sarah B Whittle, Kaitlin C Williamson, Heidi V Russell
High-risk neuroblastoma is an aggressive childhood cancer with poor outcomes. Treatment begins with an induction phase comprised of intense multi-agent chemotherapy with the goal of maximally reducing tumor bulk. Given the high intensity of induction chemotherapy, neutropenic fever and infectious complications are common; however, the actual incidence is difficult to determine from clinical trial reports. We performed a retrospective review of infection-related complications in 76 children treated for high-risk neuroblastoma at Texas Children's Hospital...
August 2017: Pediatric Hematology and Oncology
Divyaswathi Citla Sridhar, Ossama M Maher, Nidra I Rodriguez
Deep venous thrombosis (DVT) has been previously reported in children with methicillin-resistant Staphylococcus aureus (MRSA). This study reviews our institutional experience by evaluating characteristics and outcomes of children with DVT and staphylococcal infections. Retrospective clinical data from 16 pediatric patients with DVT and staphylococcal infections over a 5-year period was obtained via medical record abstraction. Sixteen patients with a median age at diagnosis of 8 years were included. The most common infection encountered was osteomyelitis (56%)...
March 2018: Journal of Pediatric Hematology/oncology
Ignacio Oulego-Erroz, Rafael González-Cortes, Patricia García-Soler, Mónica Balaguer-Gargallo, Manuel Frías-Pérez, Juan Mayordomo-Colunga, Ana Llorente-de-la-Fuente, Paula Santos-Herraiz, Juan José Menéndez-Suso, María Sánchez-Porras, Daniel Palanca-Arias, Carmen Clavero-Rubio, Mª Soledad Holanda-Peña, Luis Renter-Valdovinos, Sira Fernández-De-Miguel, Antonio Rodríguez-Núñez
PURPOSE: To assess whether ultrasound guidance improves central venous catheter placement outcomes compared to the landmark technique in critically ill children. METHODS: A prospective multicentre observational study was carried out in 26 paediatric intensive care units over 6 months. Children 0-18 years old who received a temporary central venous catheter, inserted using either ultrasound or landmark techniques, were eligible. The primary outcome was the first-attempt success rate...
January 2018: Intensive Care Medicine
Hye Min Moon, Suji Kim, Ki Wook Yun, Hyun-Young Kim, Sung Eun Jung, Eun Hwa Choi, Hoan Jong Lee
BACKGROUND: Central line-associated bloodstream infections (CLABSIs) account for significant morbidity and mortality in patients with long-term central venous catheters (CVCs). This study was performed to identify the characteristics and risk factors of CLABSIs among children with long-term CVCs. METHODS: A retrospective review of children who had a long-term CVC in Seoul National University Children's Hospital between 2011 and 2015 was performed. Data on patient demographics, the isolated pathogens, and the status of CVC placement were collected...
November 30, 2017: Pediatric Infectious Disease Journal
Fernanda Lopes de Araújo, Bruna Figueiredo Manzo, Anna Caroline Leite Costa, Allana Dos Reis Corrêa, Juliana de Oliveira Marcatto, Delma Aurélia da Silva Simão
OBJECTIVE: To describe the observed behavior of professionals in two neonatal and pediatric intensive care units regarding the use of central venous catheter insertion bundle, and the clinical and birth profile of neonates and children who received the devices. METHOD: A quantitative descriptive exploratory study was conducted in two intensive care units of a public hospital in Belo Horizonte with neonates and children, between February and September 2016. RESULTS: The sample consisted of 59 observed implants of central venous catheter...
November 27, 2017: Revista da Escola de Enfermagem da U S P
Christine L Joyce, Cosme Taipe, Brittany Sobin, Marissa Spadaro, Batsheva Gutwirth, Larissa Elgin, Gabrielle Silver, Bruce M Greenwald, Chani Traube
PURPOSE: Critically ill patients are at risk for short and long term morbidity. Early mobilization (EM) of critically ill adults is safe and feasible, with improvement in outcomes. There are limited studies evaluating EM in pediatric critical care patients. Provider beliefs and concerns must be evaluated prior to EM implementation in the pediatric intensive care unit (PICU). DESIGN AND METHODS: A survey was distributed to PICU providers assessing beliefs and concerns with regards to EM of PICU patients...
January 2018: Journal of Pediatric Nursing
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