Peripherally inserted central catheter infections in burn patients

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“A retrospective chart review was performed of all burn patients with a PICC admitted to our regional burn center from 2006 to 2008.” Barsun et al (2014).

Reference:

Barsun, A., Sen, S., Palmieri, T.L. and Greenhalgh, D.G. (2014) Peripherally Inserted Central Line Catheter Infections in Burn Patients. Journal of Burn Care & Research. July 22nd. [epub ahead of print].

Abstract:

Peripherally inserted central line catheter (PICC) use has increased in burn patients. While the risks of central line associated blood stream infections (CLABSI) in burn patients have been well studied, the risks of PICC infections have yet to be fully elucidated. A retrospective chart review was performed of all burn patients with a PICC admitted to our regional burn center from 2006 to 2008. Information collected included: age, total body surface area (TBSA) burn injury, length of hospital stay, duration of PICC line insertion, hospital day of PICC line insertion, and development of infections. All mean values are presented as the mean ± standard error. A total of 56 patients received a PICC during this time period. Eight patients developed PICC infections with an overall rate of 11.7/1000 catheter days. Burn patient CLABSI for the same time period was 12.9/1000 catheter days. Duration of PICC did not differ between infected and noninfected patients (13.3 ± 6 vs. 12.1 ± 9.6 days). Patients with PICC infections had a higher percentage of TBSA (42.7 ± 3.2 vs. 20.6 ± 2.4*), longer length of admission (72.4 ± 6 vs. 35 ± 3.2*), and later hospital day of PICC insertion (48 ± 4.6 vs. 17.1 ± 2.5*). On linear regression analysis, PICC infection was significantly associated with TBSA (B = 22.1*), length of admission (B = 37.4*), and hospital day of PICC insertion (B = 30.3*). On multivariate analysis, TBSA (Odds ratio [OR] = 1.05*), length of admission (OR = 1.04*), and hospital day of PICC insertion (OR = 1.05*) all independently increased the risk of developing a PICC infection. Patients with severe burn injury, long hospital admissions, and later hospital day of PICC insertions are at higher risk of developing PICC infections. This data suggests that protocols should be developed about routine PICC changes in this high-risk burn population.

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