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J Matern Fetal Neonatal Med ; 29(24): 4082-7, 2016 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-26987639

RESUMO

OBJECTIVE: To compare clinical outcomes and hospital resource utilization of infants who had peripherally inserted central catheters removed early versus retained following diagnosis of central line-associated bloodstream infection. STUDY DESIGN: In a single centre retrospective cohort study, we compared outcomes of infants who had peripherally inserted central catheters removed early versus retained after diagnosis of central line-associated bloodstream infection. Mortality, cardio-respiratory deterioration, use of blood products and antibiotics were compared between groups. RESULTS: Over a 10-year period, of the 119 eligible infants, 38 had peripherally inserted central catheters removed early and 81 had catheters retained after diagnosis of central line-associated bloodstream infection. Baseline demographics, illness severity at onset of sepsis and distribution of organisms were similar between the groups. Infants in "catheter-retained" group required longer antibiotic usage (17 ± 9 versus 13 ± 6 days; p = 0.025) and more frequent sequential positive blood cultures [31/81 (47%) versus 8/38 (22%), p = 0.014). Infants with Gram-negative bacteremia demonstrated higher mortality when catheters were retained [43% (9/21) versus 7% (1/14); p = 0.028]. CONCLUSIONS: Retaining peripherally inserted central catheters after diagnosis of central line-associated bloodstream infection was associated with longer duration of bacteremia and prolonged exposure to systemic antibiotics as well as increased mortality in Gram-negative bacteremia.


Assuntos
Infecções Relacionadas a Cateter/terapia , Cateterismo Periférico/efeitos adversos , Cateteres de Demora/efeitos adversos , Cateteres Venosos Centrais/efeitos adversos , Remoção de Dispositivo/estatística & dados numéricos , Antibacterianos/uso terapêutico , Infecções Relacionadas a Cateter/diagnóstico , Infecções Relacionadas a Cateter/mortalidade , Feminino , Idade Gestacional , Humanos , Recém-Nascido , Masculino , Sepse Neonatal/diagnóstico , Sepse Neonatal/mortalidade , Razão de Chances , Estudos Retrospectivos , Índice de Gravidade de Doença , Estatísticas não Paramétricas , Fatores de Tempo
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