Vascular injury due to a peripherally inserted central catheter in a neonate born during the 24<sup>th</sup> week of gestation

Kurimoto, Tomonori; Yonishi, Ryo; Uehara, Hirotaka; Fukuzato, Hayato; Seki, Satoko; Shimoji, Yoshikazu; Nakayama, Okitaka; Ohba, Chiaki; Nakazato, Iwao; Ohshiro, Tatsuo

doi:10.1002/ccr3.5991

Cited by 4 publications

(3 citation statements)

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“…Some scholars prospectively studied the risk factors of nosocomial infection in neonates in ICU, and the results showed that birth weight <1 kg was the largest risk factor of nosocomial infection in neonates. [ 7 , 22 ] The 5-minute APGAR score of newborns refers to the basis for the diagnosis and classification of neonatal asphyxia 5 minutes after birth. A multicenter case–control study showed that the birth weight ≤1500 g and the 5-minute APGAR score <7 points after birth increased the risk of neonatal CRBSI.…”

Section: Discussionmentioning

confidence: 99%

Analysis and risk factors of deep vein catheterization-related bloodstream infections in neonates

Zhang,

Li,

et al. 2024

Medicine

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To investigate the incidence, risk factors, and pathogenic characteristics of catheter-related bloodstream infection caused by peripherally inserted central venous catheter in neonates, and to provide references for reducing the infection rate of peripherally inserted central venous catheter. The clinical data of 680 neonates who underwent peripherally inserted central catheter (PICC) in the neonatal intensive care unit from June 2020 to June 2023 were retrospectively analyzed. The risk factors and independent risk factors of catheter-related bloodstream infection caused by PICC were determined by univariate and multivariate analysis, respectively. Catheter-related bloodstream infection occurred in 38 of 680 neonates who underwent PICC. The infection rate was 4.74%. The proportions of fungi, gram-positive bacteria, and gram-negative bacteria were 42.11%, 36.84%, and 21.05%, respectively. Candida parapsilosis was the main fungus (18.42%), coagulase negative Staphylococcus was the main gram-positive bacteria (23.68%), and Klebsiella pneumoniae and Escherichia coli were the main gram-negative bacteria (7.89%). Univariate analysis showed that gestational age ≤32 weeks, birth weight ≤1500 g, congenital diseases, nutritional support, catheterization time, 5-minute APGAR score ≤7, and neonatal respiratory distress syndrome were associated with catheter-related bloodstream infection caused by PICC. Multivariate analysis showed that premature delivery, low birth weight, parenteral nutrition, long catheterization time, and 5-minute APGAR score ≤7 were associated with catheter-related bloodstream infection caused by PICC. Among the pathogens detected, there were 6 cases of K pneumoniae, 5 cases of coagulase negative staphylococci, and 2 cases of fungi. Low birth weight, premature delivery, off-site nutrition, long catheterization time, and 5-minute APGAR score ≤7 are independent risk factors for catheter-related bloodstream infection in neonates with peripherally inserted central venous catheters. The pathogenic bacteria are fungi and multidrug-resistant bacteria.

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Section: Discussionmentioning

confidence: 99%

Analysis and risk factors of deep vein catheterization-related bloodstream infections in neonates

Zhang,

Li,

et al. 2024

Medicine

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“…If symptoms are persistent and challenging to treat, a constant intravenous calcium infusion is obligatory. 29,30 Once the acute symptoms have resolved, calcium and vitamin D supplements should be given. In our case, our patient required a continuous intravenous calcium drip due to the severity of their acute symptomatic hypocalcaemia at the time of admission.…”

Section: Discussionmentioning

confidence: 99%

Fahr’s syndrome associated with hypoparathyroidism: A case report

Sarna,

Goel,

Bhargava

et al. 2023

Journal of the Royal College of Physicians of Edinburgh

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Fahr’s syndrome affects fewer than 1 in 100,000 people. It is an inherited neurological disorder, which is distinguished by atypical calcium deposition in the movement-controlling areas of brain, that is thalamus, dentate nucleus, basal ganglia, cerebellum, cerebral cortex, hippocampus and subcortical white matter. The majority of patients often experience extrapyramidal symptoms, cerebellar signs, speech difficulty, dementia and neuropsychiatric manifestations. This disease’s molecular genetics have not been thoroughly investigated. Typically, young to middle-aged adults are affected though basal ganglia calcification in hypoparathyroidism is quite uncommon. Laboratory results and radiographic brain imaging helps in reaching the diagnosis. The treatment is mainly symptomatic. We present a case of Fahr’s syndrome associated with hypoparathyroidism.

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“…The inward or outward migration of PICC tips can occur either soon after their insertion or at any time while in situ [ 7 – 10 ]. Inward catheter migration can cause complications such as cardiac tamponade or arrhythmias and outward catheter migration (catheter tip position in a non-central vein) can cause complications such as thrombosis, extravasation and vascular injury [ 11 – 13 ]. Therefore, timely detection of PICC malposition and migration is imperative to prevent these serious complications.…”

Section: Introductionmentioning

confidence: 99%

Role of a radiopaque agent and surveillance radiographs for peripherally inserted central catheters in newborn infants

Stekhova,

Kodur,

Lowe

et al. 2023

Pediatr Radiol

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Background Controversy exists regarding the use of a radiopaque agent to identify peripherally inserted central catheter (PICC) tip positions in newborn infants and of serial radiography to monitor PICC tip migration. Objective To investigate the roles of (1) the injection of a radiopaque agent to identify PICC tip position and (2) the performance of weekly radiography to monitor PICC migration. Materials and methods This retrospective single-centre cohort study included newborn infants who received a PICC between 1 January 2016 and 31 December 2020. A radiopaque agent was injected to identify PICC tip position and radiographs were performed weekly to detect PICC migration. Results We identified 676 PICC episodes in 601 infants. A radiopaque agent was used for 590 of these episodes. There was no difference in the proportion of central PICC tip positions based on radiopaque agent use status (490/590, 83% for the radiopaque agent used group versus 73/85, 85.8% for the radiopaque agent not used group, P=0.51). Irrespective of the site of PICC insertion, outward migration was observed for most centrally placed PICCs over their entire in situ duration. Inward migration was identified in 23 out of 643 PICC episodes (3.6%) only on radiographs obtained on or before day 7. Based on serial radiographs, the odds for PICC tips remaining in a central position were lower the longer the PICC remained in situ (adjusted odds ratio-OR 0.93; 95% confidence interval 0.92–0.95). There was no difference in PICC migration between side and limb of insertion. Conclusion PICC tips can be identified without injection of a radiopaque agent. Serial radiographs identified PICC migration over the in situ duration. This study has implications for reducing exposure to a radiopaque agent and ongoing migration surveillance practices. Graphical abstract

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Vascular injury due to a peripherally inserted central catheter in a neonate born during the 24^th week of gestation

Cited by 4 publications

References 4 publications

Analysis and risk factors of deep vein catheterization-related bloodstream infections in neonates

Analysis and risk factors of deep vein catheterization-related bloodstream infections in neonates

Fahr’s syndrome associated with hypoparathyroidism: A case report

Role of a radiopaque agent and surveillance radiographs for peripherally inserted central catheters in newborn infants

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Vascular injury due to a peripherally inserted central catheter in a neonate born during the 24th week of gestation

Cited by 4 publications

References 4 publications

Analysis and risk factors of deep vein catheterization-related bloodstream infections in neonates

Analysis and risk factors of deep vein catheterization-related bloodstream infections in neonates

Fahr’s syndrome associated with hypoparathyroidism: A case report

Role of a radiopaque agent and surveillance radiographs for peripherally inserted central catheters in newborn infants

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Vascular injury due to a peripherally inserted central catheter in a neonate born during the 24^th week of gestation