Are antimicrobial peripherally inserted central catheters associated with reduction in central line–associated bloodstream infection? A systematic review and meta-analysis

2017 ◽  
Vol 45 (2) ◽  
pp. 108-114 ◽  
Author(s):  
Rachel D. Kramer ◽  
Mary A.M. Rogers ◽  
Marisa Conte ◽  
Jason Mann ◽  
Sanjay Saint ◽  
...  
Keyword(s):  
Systematic Review ◽  
Bloodstream Infection ◽  
Meta Analysis ◽  
Central Line ◽  
Peripherally Inserted Central Catheters ◽  
Central Catheters

Types of Interventions

2021 ◽  
pp. 40-51
Author(s):  
Jennifer Meddings ◽  
Vineet Chopra ◽  
Sanjay Saint
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Bloodstream Infection ◽  
Infection Prevention ◽  
Central Line ◽  
Peripherally Inserted Central Catheters ◽  
Trade Off ◽  
Central Lines ◽  
The Past ◽  
Central Catheters

Prevention of central line–associated bloodstream infection (CLABSI), while initially making great strides in 2003, has declined as use of peripherally inserted central catheters (PICCs) has grown tremendously over the past two decades. The convenience of a PICC has led to sicker patients being treated outside the intensive care unit, and there has been little recognition of a trade-off between benefits and risks after PICC placement. For these reasons, CLABSI prevention has become more challenging. This chapter describes the contents of an infection prevention bundle for CLABSI. In the case of CLABSI, the intervention outlines appropriate and inappropriate uses of central lines. Several new tools are discussed, which help doctors and nurses think through which device is most appropriate for any given patient.

scholarly journals 831: Complications of peripherally inserted central catheters in pregnancy: a systematic review and meta-analysis.

2019 ◽  
Vol 220 (1) ◽  
pp. S542-S543
Author(s):  
Antonina I. Frolova ◽  
Matthew A. Shanahan ◽  
Metthodius G. Tuuli ◽  
Laura E. Simon ◽  
Omar M. Young
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Peripherally Inserted Central Catheters ◽  
Central Catheters ◽  
In Pregnancy

Risk of venous thromboembolism associated with peripherally inserted central catheters: a systematic review and meta-analysis

The Lancet ◽  
2013 ◽  
Vol 382 (9889) ◽  
pp. 311-325 ◽  
Author(s):  
Vineet Chopra ◽  
Sarah Anand ◽  
Andy Hickner ◽  
Michael Buist ◽  
Mary AM Rogers ◽  
...  
Keyword(s):  
Systematic Review ◽  
Venous Thromboembolism ◽  
Meta Analysis ◽  
Peripherally Inserted Central Catheters ◽  
Central Catheters

Peripherally inserted central catheters inserted with current best practices have low deep vein thrombosis and central line–associated bloodstream infection risk compared with centrally inserted central catheters: A contemporary meta-analysis

2020 ◽  
pp. 112972982091611 ◽  
Author(s):  
Gregory J Schears ◽  
Nicole Ferko ◽  
Imran Syed ◽  
John-Michael Arpino ◽  
Kimberly Alsbrooks
Keyword(s):  
Deep Vein Thrombosis ◽  
Best Practices ◽  
Meta Analysis ◽  
Central Line ◽  
Peripherally Inserted Central Catheters ◽  
Vein Thrombosis ◽  
Thrombosis Risk ◽  
Increased Risk ◽  
Deep Vein ◽  
Central Catheters

Background: Peripherally inserted central catheters and centrally inserted central catheters have numerous benefits but can be associated with risks. This meta-analysis compared central catheters for relevant clinical outcomes using recent studies more likely to coincide with practice guidelines. Methods: Several databases, Ovid MEDLINE, Embase, and EBM Reviews were searched for articles (2006–2018) that compared central catheters. Analyses were limited to peer-reviewed studies comparing peripherally inserted central catheters to centrally inserted central catheters for deep vein thrombosis and/or central line–associated bloodstream infections. Subgroup, sensitivity analyses, and patient-reported measures were included. Risk ratios, incidence rate ratios, and weighted event risks were reported. Study quality assessment was conducted using Newcastle–Ottawa and Cochrane Risk of Bias scales. Results: Of 4609 screened abstracts, 31 studies were included in these meta-analyses. Across studies, peripherally inserted central catheters were protective for central line–associated bloodstream infection (incidence rate ratio = 0.52, 95% confidence interval: 0.30–0.92), with consistent results across subgroups. Peripherally inserted central catheters were associated with an increased risk of deep vein thrombosis (risk ratio = 2.08, 95% confidence interval: 1.47–2.94); however, smaller diameter and single-lumen peripherally inserted central catheters were no longer associated with increased risk. The absolute risk of deep vein thrombosis was calculated to 2.3% and 3.9% for smaller diameter peripherally inserted central catheters and centrally inserted central catheters, respectively. On average, peripherally inserted central catheter patients had 11.6 more catheter days than centrally inserted central catheter patients ( p = 0.064). Patient outcomes favored peripherally inserted central catheters. Conclusion: When adhering to best practices, this study demonstrated that concerns related to peripherally inserted central catheters and deep vein thrombosis risk are minimized. Dramatic changes to clinical practice over the last 10 years have helped to address past issues with central catheters and complication risk. Given the lower rate of complications when following current guidelines, clinicians should prioritize central line choice based on patient therapeutic needs, rather than fear of complications. Future research should continue to consider contemporary literature over antiquated data, such that it recognizes the implications of best practices in modern central catheterization.

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