Details

Autor(en) / Beteiligte

• Chan, Katelyn S.
• Martin, Nolan
• Rafeeqi, Talha
• Salimi-Jazi, Fereshteh
• Chao, Stephanie

Titel

Complications associated with subsequent vascular access in pediatric ECMO patients

Ist Teil von

• Journal of pediatric surgery, 2023-11, Vol.58 (11), p.2201-2205

Ort / Verlag

Elsevier Inc

Erscheinungsjahr

2023

Link zum Volltext

Quelle

Alma/SFX Local Collection

Beschreibungen/Notizen

• Following ECMO decannulation, intensivists and surgeons must consider whether to reuse the cannulation site for central venous catheters (CVC) or seek remote access. This study investigates the risk of infectious complication associated with the reuse of peripheral ECMO cannulation sites for subsequent central venous access. A retrospective review was conducted for patients aged 0-18 years, who underwent peripheral ECMO cannulation between 2009 and 2021 at a single children’s hospital. Of the 227 charts reviewed, after ECMO decannulation, 53 patients received a CVC at the same location, 25 received a CVC at a different location, 62 received a peripherally inserted central catheter (PICC), and 87 had no subsequent vascular access placed within 30 days of decannulation. Patients with secondary access placed at the same site experienced 1 CLABSI, or 0.94 CLABSIs per 1000 line days. Patients with PICC lines after ECMO decannulation had 1 CLABSI, or 0.43 CLABSIs per 1000 line days. In comparison, the institution’s hospital-wide CLABSI rate was 1.46 per 1000 line days during this same period. Although the rate of CLABSI among patients with secondary access at the site of decannulation was higher than the rate among patients with PICC lines (p=0.79) it was lower than the institutional rate (p=0.54), these differences did not rise to the level of statistical significance. Compared with ECMO patients with subsequent CVCs placed at an alternative access site or via PICC after decannulation, patients with contemporaneous CVC placement at the site of decannulation do not experience a significantly higher rate of CLABSIs. Level III •Central venous access can be particularly difficult to obtain following ECMO decannulation in the pediatric population.•There is no significantly increased risk of infectious complication associated with the reuse of an ECMO cannulation site for subsequent vascular access compared with alternative access sites.