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- Title
Central Line Infection and Non-Infectious Complications in a Canadian Intensive Care Unit.
- Authors
Cheung, Christopher C.; Kutsogiannis, Demetrios J.
- Abstract
INTRODUCTION: Central lines (CL) are routinely placed in critically ill patients in the Intensive Care Unit (ICU) for the intravenous administration of fluids, nutrition, and medication. However, CL can predispose a patient to complications, with reported CL-related infection rates up to 10%. We examined the incidence and risk factors for developing CL-related infections and non-infectious complications. METHODS: In this prospective observational study from 2008-2009, CL progress reports were reviewed for 1362 line insertions at the ICU at the Royal Alexandra Hospital in Edmonton, AB. Population statistics, univariate and multivariate logistic regression analysis were used. RESULTS: There were 995 CL established on first insertion, 262 on second insertion, and 103 lines requiring >2 insertions, in patients with APACHE-II scores of 24.6+/-7.73 (mean+/-SD). CL were inserted by residents (45 %), nurse practitioners (12%), anaesthesiologists (8%), radiologists (3%), attending physicians (2%), and unknown (30%); in the ICU (60%), ER (17%), OR (8%), other hospitals (6%), wards (2%), and other locations (7%). CL insertion bundles were used for all patients (>98%). There were CL-related infections (n=12, 0.88%) and non-infectious complications (n=38, 2.79%): of the 38 non-infectious complications, there were arterial cannulations (47%), pneumothoraxes (16%), failed attempts at other sites (16%), bleeding (11%), and others (10%). Univariate analysis revealed no association between complications and line administrator or use of total parenteral nutrition (TPN), but significant association between infection and APACHE-II score (p<0.05). Multivariate regression including line administrator, use of TPN, insertion site, location, and APACHE-II identified APACHE-II score as an independent predictor of infection (OR=1.10, p=0.01). CONCLUSIONS: We demonstrate a low infection and non-infectious complication rate in CL, below that reported in literature, in a Canadian ICU. These results suggest increasing APACHE-II score to be a strong independent predictor for CL-related infection.
- Subjects
CANADA; INTENSIVE care units; INTRAVENOUS therapy; LOGISTIC regression analysis; INFECTION
- Publication
UBC Medical Journal, 2011, Vol 2, Issue 2, p17
- ISSN
1920-7425
- Publication type
Abstract