Background: Patients with inflammatory bowel disease (IBD) occasionally require central venous catheter (CVC) placement to support a therapeutic plan. Given that CVC can predispose patients to infection, this investigation was undertaken to assess the incidence, risk factors, and outcomes of CVC-related blood stream infection (CRBSI) in patients with IBD during routine clinical practice.
Methods: Data were compiled using retrospective chart reviews of 1367 patients treated at our IBD center between 2007 and 2012 during routine clinical practice. Among the 1367 patients, 314 who had received CVC placements were included. Patients with positive blood culture were considered as "definite" CRBSI, whereas "possible" CRBSI was defined as patients in whom fever alleviated within 48 hours post-CVC without any other infection. Patients' demographic variables including age, body mass index, serum albumin, duration of CVC placement, use of antibiotics, medications for IBD, and perioperative status between CRBSI and non-CRBSI subgroups were compared by applying a multivariate Poisson logistic regression model.
Results: Among the 314 patients with CVC placement, there were 83 CRBSI cases (26.4%). The average time to the onset of CRBSI was 22.5 days (range 4-105 days). The jugular vein access was found to be the most serious risk of CRBSI (risk ratio 2.041 versus subclavian vein). All patients with CRBSI fully recovered.
Conclusions: In this investigation, regardless of the patients' demographic features including immunosuppressive therapy, up to 30% of febrile IBD patients with CVC showed CRBSI. It is believed that CVC placement per se is a risk of CRBSI in patients with IBD.
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http://dx.doi.org/10.1097/MIB.0000000000001230 | DOI Listing |
JA Clin Rep
December 2024
Department of Anesthesiology, Yokohama Municipal Citizen's Hospital, Yokohama, Japan.
Background: The standard of care for placement of a central venous catheter (CVC) includes a real-time ultrasound (US)-guided technique. We describe a rare case in which the guidewire penetrated the posterior wall of the vessel, forming a knot, which precluded simple removal. This occurred despite the procedure being performed under real-time US guidance.
View Article and Find Full Text PDFIndian J Anaesth
November 2024
Department of Anesthesiology and Critical Care, AIIMS, Bhubaneswar, Odisha, India.
Background And Aims: Various methods are used to predict the depth of insertion of central venous catheters (CVCs). We evaluated a bronchoscopy-based carinal measurement technique to predict this depth.
Methods: We randomised adults undergoing cardiac surgery into a bronchoscopy group or the Peres' formula-based method group.
Heliyon
November 2024
Department of Anesthesiology, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou City, 510630, Guangdong Province, China.
BMJ Case Rep
December 2024
Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, India.
A central venous catheter (CVC) was placed in the left internal jugular vein of a woman in her late 20s, who was admitted to our intensive care unit during the management of her abdominal wall sepsis. Two days later, the patient had pain at the insertion site. Check aspiration revealed the presence of aspirate from all the lumens except the distal lumen.
View Article and Find Full Text PDFCardiovasc Eng Technol
December 2024
Department of Biomedical Engineering, The Pennsylvania State University, 122 Chemical and Biomedical Engineering Building, University Park, PA, USA.
Purpose: Central venous catheters (CVCs) provide a direct route to the venous circulation but are prone to catheter-related thrombosis (CRT). A known CRT risk factor is a high catheter-to-vein ratio (CVR), or a large catheter diameter with respect to the indwelling vein size. In this study, the CVR's effect on CVC hemodynamics and its impact on CRT is investigated with in vitro and in silico experiments.
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