Catheter-associated bloodstream infections and thrombotic risk in hematologic patients with peripherally inserted central catheters (PICC)

Morano, Salvatore Giacomo; Latagliata, Roberto; Girmenia, Corrado; Massaro, Fulvio; Berneschi, Paola; Guerriero, A.; Giampaoletti, Massimo; Sammarco, Arianna; Annechini, Giorgia; Famà, Angelo; Rocco, Alice Di; Chistolini, Antonio; Micozzi, Alessandra; Molica, Matteo; Barberi, Walter; Minotti, Clara; Brunetti, Gregorio Antonio; Breccia, Massimo; Cartoni, Claudio; Capria, Saveria; Rosa, Giovanni; Foà, Robin

doi:10.1007/s00520-015-2740-7

Cited by 46 publications

(48 citation statements)

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“…A literature review by Chopra and colleagues 3 showed higher rates of PICC-related bloodstream infections among adult patients with cancer than among those without cancer (1.1/1000 catheter days v. 1.8-7.7/1000 catheter days). Morano and colleagues 18 reported on 612 patients with hematological disease with primarily (86.8% of patients) 4 French single-lumen distally valved silicone PICCs (Groshong [Bard Peripheral Vascular]); the incidence of catheter-related bloodstream infection was 7.7%, or 0.59/ 1000 catheter days, and the mean dwell time was 101 days.…”

Section: Discussionmentioning

confidence: 99%

Outcomes in a nurse-led peripherally inserted central catheter program: a retrospective cohort study

et al. 2017

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Background: Peripherally inserted central catheters (PICCs) provide enormous benefit to patients. However, recent publications have highlighted relatively high PICC-associated complication rates. We report on patient and device outcomes from a nurse-led program. Methods:We performed a retrospective analysis of a prospective cohort of consecutive patients undergoing PICC insertion at The Ottawa Hospital between Jan. 1, 2013 and Dec. 31, 2014. Of the 8314 BioFlo PASV PICCs inserted, we randomly selected a sample of 700 and obtained a complete data set for 656. We measured the cumulative incidence of major complications (catheterrelated bloodstream infections and deep vein thrombosis) and use of a thrombolytic to alleviate occlusions. Results:The total number of catheter days was 58 486, and the median dwell time 45 days. We observed 4 cases of catheterrelated bloodstream infection (0.6% [95% CI 0.17%-1.55%]) (0.07/1000 catheter days). Ten patients (1.5% [95% CI 0.83%-2.78%]) (0.17/1000 catheter days) had catheter-related deep venous thrombosis. At least 1 dose of thrombolytic was required in 75 catheters (11.4% [95% CI 8.61%-13.39]), 31 (7.1%) of the 436 single-lumen catheters and 113 (25.7%) of the 440 lumina of dual-lumen catheters (p < 0.001). Interpretation:We attribute our low rates of major complications to a nurse-led expert insertion team, standardized care and maintenance protocols, high insertion volumes, novel catheter material and continuous quality-improvement initiatives that are implemented and evaluated regularly. We conclude that the considerable benefits PICCs provide to patients are attained with a low risk of major complications. Abstract ResearchResearch CMAJ OPEN E536CMAJ OPEN, 5(3)

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Section: Discussionmentioning

confidence: 99%

Outcomes in a nurse-led peripherally inserted central catheter program: a retrospective cohort study

et al. 2017

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“…And they are easy to insert, and associated to a low rate of early and late complications compared to conventional percutaneous method. Furthermore, PICCs are also easy to remove and less expensive than some other devices 4, 5 . However, PICCs have their own risks, such as infection, phlebitis and thrombosis 6 .…”

Section: Introductionmentioning

confidence: 99%

Nomogram predicted risk of peripherally inserted central catheter related thrombosis

Hao

Xie

Zhou

et al. 2017

Sci Rep

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The use of peripherally inserted central catheters (PICCs) is increasing rapidly worldwide. A number of patient-related, clinical-related and device-related characteristics might be risk factors for PICC-related thrombosis. We retrospectively reviewed a database of 320 consecutive patients who underwent PICC insertion between December 2014 and December 2015 at the First Affiliated Hospital of Xi’an Jiaotong University to explore the potential associations between risk factors and PICC-associated thrombosis. A novel nomogram for predicting risk was developed based on the data. The nomogram prediction model included ten risk factors that were derived from different relevant estimates. The nomogram prediction model showed good discriminatory power (Harrell’s C-index, 0.709) and a high degree of similarity to actual thrombosis occurring after calibration. Furthermore, principal component analysis was performed to identify the factors that most influence PICC-related thrombosis. Our novel nomogram thrombosis risk prediction model was accurate in predicting PICC-related thrombosis. Karnofsky performance scores, D-dimer and blood platelet levels and previous chemotherapy were principal components. Our findings might help clinicians predict thrombosis risk in individual patients, select proper therapeutic strategies and optimize the timing of anticoagulation therapy.

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“…These complications significantly decrease quality of life among patients and lead to additional expense. Serious thrombosis complications and PICC infections have been mostly studied (Del Principe et al., ; Morano et al., ; Yi et al., ). Previous studies demonstrated that lower incidence of catheter‐related bloodstream infection (CRBSI) was observed in patients with PICCs compared to other CVCs (Al Raiy et al., ; Gunst et al., ).…”

Section: Introductionmentioning

confidence: 99%

Complications of peripherally inserted central catheters in advanced cancer patients undergoing combined radiotherapy and chemotherapy

Xie

et al. 2017

Journal of Clinical Nursing

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Catheter-associated bloodstream infections and thrombotic risk in hematologic patients with peripherally inserted central catheters (PICC)

Abstract: PICCs represent a useful and safe alternative to conventional CVAD for the management of patients with hematologic malignancies.

Cited by 46 publications

References 20 publications

Outcomes in a nurse-led peripherally inserted central catheter program: a retrospective cohort study

Outcomes in a nurse-led peripherally inserted central catheter program: a retrospective cohort study

Nomogram predicted risk of peripherally inserted central catheter related thrombosis

Complications of peripherally inserted central catheters in advanced cancer patients undergoing combined radiotherapy and chemotherapy

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