Catheter salvage from central line-related bloodstream infections in pediatric intestinal failure

Catherine Larson-Nath, Linder Wendt, Riad Rahhal

Research output: Contribution to journalArticlepeer-review

Abstract

Objectives: Patients with intestinal failure require central venous access which puts them at risk for central line-associated bloodstream infections (CLABSI). Maintaining vascular patency is critical for this population to receive nutrition support. When CLABSIs occur line salvage can help maintain vascular access. The aim of this study is to assess factors associated with safe and successful central venous catheter salvage. Methods: Retrospective cohort study of patients with intestinal failure at two tertiary care institutions between 2012 and 2020. The study examined the rates of attempted salvage, factors associated with successful salvage, and complications associated with salvage attempts. Results: Over the study period, 76 patients with intestinal failure were include while central venous access was in place. There were a total of 94 CLABSIs. Salvage was more likely to be attempted when patients were under the direct care of an intestinal rehabilitation service (95% vs. 68%, p = 0.04). The overall successful salvage rate was 91.6% (n = 77). Gram-positive, Gram-negative, and polymicrobial infections had successful salvage rates of 97%, 92%, and 94% respectively. The successful salvage rate for fungal infections was 40%. There was no difference in 30-day complication rates for hospital readmission, intensive care unit admission, and death between patients who underwent salvage attempt and those who did not. Conclusions: Central line salvage can be safely attempted for many infections in patients with intestinal failure, leading to vascular access preservation.

Original languageEnglish (US)
Pages (from-to)918-926
Number of pages9
JournalJournal of pediatric gastroenterology and nutrition
Volume78
Issue number4
DOIs
StatePublished - Apr 2024

Bibliographical note

Publisher Copyright:
© 2024 The Authors. Journal of Pediatric Gastroenterology and Nutrition published by Wiley Periodicals LLC on behalf of European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition.

Keywords

  • central venous catheter
  • home
  • parenteral nutrition
  • sepsis

PubMed: MeSH publication types

  • Journal Article

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