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- Title
Impact of subcutaneous tunnels on peripherally inserted catheter placement: a multicenter retrospective study.
- Authors
Kim, Il Jung; Shim, Dong Jae; Lee, Jae Hwan; Kim, Eung Tae; Byeon, Jong Hyun; Lee, Hun Jae; Cho, Soon Gu
- Abstract
<bold>Objective: </bold>To evaluate the impact of subcutaneous tunneling on peripherally inserted central catheter (PICC) placement in terms of central line-associated bloodstream infections (CLABSIs).<bold>Methods: </bold>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.<bold>Results: </bold>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.<bold>Conclusions: </bold>Compared with conventional means, a subcutaneous tunneling approach for PICC placement significantly reduces the rate of CLABSI.<bold>Key Points: </bold>• 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.
- Subjects
SOUTH Korea; PERIPHERALLY inserted central catheters; CATHETERIZATION; TUNNELS; INTENSIVE care units; COMPARATIVE studies; INTRAVENOUS catheterization; RESEARCH methodology; MEDICAL cooperation; RESEARCH; VENOUS thrombosis; EVALUATION research; DISEASE incidence; RETROSPECTIVE studies; CATHETER-related infections
- Publication
European Radiology, 2019, Vol 29, Issue 5, p2716
- ISSN
0938-7994
- Publication type
journal article
- DOI
10.1007/s00330-018-5917-x