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Comparative Study
. 2012 Jun;160(6):972-7.e2.
doi: 10.1016/j.jpeds.2011.12.004. Epub 2012 Jan 10.

An evidence-based catheter bundle alters central venous catheter strategy in newborn infants

Meggan Butler-O'Hara  1 , Carl T D'Angio, Hyacinth Hoey, Timothy P Stevens
Affiliations
Comparative Study

An evidence-based catheter bundle alters central venous catheter strategy in newborn infants

Meggan Butler-O'Hara et al. J Pediatr. 2012 Jun.

Abstract

Objective: To assess whether introduction of an evidence-based percutaneously inserted central catheter (PICC) care bundle reduced the risk of central line-associated bloodstream infection (CLABSI), thus altering the comparative risk of CLABSI in infants.

Study design: This retrospective cohort study included all infants for whom an umbilical venous catheter (UVC) was placed as part of routine care between Jan 1, 2006, and Dec 31, 2009, a period during which standardized PICC insertion and care bundles were introduced. Duration of UVC use was divided in ≤ 7 days and >7 days.

Results: Infants in the ≤ 7 days UVC group had 1.0 CLABSI/1000 catheter days, and infants in the >7 days UVC group had 4.0 CLABSI/1000 catheter days (P < .001). Controlling for birth weight, gestational age, and antibiotic use, the >7 days UVC group had a greater risk of CLABSI (OR, 5.48) than the ≤ 7 days UVC group. CLABSI rate increased more rapidly in UVC than PICC with increasing duration of catheter rose.

Conclusions: Replacement of a UVC with a PICC when central venous access is needed after 7 days of age may reduce CLABSI.

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