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Evaluation of Infection Development and Causes about Central Venous Catheter Interventions in Pediatric Cardiovascular Surgical Intensive Care Unit: Retrospective Study

Year 2023, Volume: 6 Issue: 2, 265 - 272, 01.09.2023

İrem Habibe Taşdelen Türkinaz Aştı Funda Büyükyılmaz

https://doi.org/10.38108/ouhcd.1012803

Abstract

Objective: This study was carried out to evaluate the development and cause of infection in central venous catheter applications in pediatric cardiovascular surgery intensive care unit patients.
Methods: This retrospective-cross sectional study consisted of 317 patients’ data who were treated and followed in a pediatric cardiovascular intensive care unit in a private hospital. The sample included data on patients who applied a central venous catheter from patients’ data (n=70). The patient record was obtained from the archive of the hospital the statistical significance level was accepted as p<0.05.
Results: The mean age of the patients was 2.21±1.14 months. Most of the patients (57.1%) were operated because of cyanotic heart disease, the mean duration of treatment was 1.37±0.48 days and the mean dwell time of the central venous catheter was 1.54±0.50 days. It was determined that 37.1% of the patients had central venous catheter insertion sites and 44.3% had systemic infections. It was determined that the incidence of infection at the catheter insertion site was high in patients with a length of stay of 1-5 days in the intensive care unit. In addition, it was determined that the probability of infection in patients with 6-10 days of catheter stay was 7.15 times higher (p≤0.05).
Conclusion: It was concluded that the length of stay (1-5 days) in the pediatric cardiovascular intensive care unit and the length of catheter duration (6 days or more) increased the incidence and probability of infection at the catheter-site.

Keywords

Central venous catheter nursing care infection pediatrics intensive care

References

  • Abedin S, Kapoor G. (2008). Peripherally inserted central venous catheters are a good option for prolonged venous access in children with cancer. Pediatric Blood Cancer, 51, 251-255. https://doi.org/10.1002/pbc.21 344. Centers for Disease Control and Prevention (CDC)https://www.cdc.gov/ 2011 Guidelines for the Prevention of Intravascular Catheter Related Infections. Erişim tarihi:10.01.2019, https://www.cdc.gov/infectioncontrol/guidelines/bsi/recommendations.html
  • Çıtak A, Karaböcüoğlu M, Üçsel R, Uzel N. (2002). Central venous catheters in pediatric patients-subclavian venous approach as the first choice. Pediatrics International, 44, 83-86. https://doi.org/10.1046/j.1442-200X.2002.01509.x
  • Fadoo Z, Nisar MI, Iftikhar R, Ali S, Mushtaq N, Sayani R. (2015). Peripherally inserted central venous catheters in pediatric hematology/oncology patients in tertiary care setting: A developing country experience. Journal of Pediatric Hematological Oncology, 37, 421-423. https://doi.org/10.1097/MPH.000000000 0000369
  • Gerçeker G, Yardımcı F, Aydınok Y. (2017). Randomized controlled trial of care bundles with chlorhexidine dressing and advanced dressing to prevent catheter related bloodstream infections in pediatric hematology-oncolohy patients. European Journal of Oncology Nursing, 28, 14-20. https://doi.org/10.1016/j.ejon.2017.02.008
  • Gorski LA. (2017). The 2016 infusion therapy standards of practice. Home Healthcare Now, 35, 10-18. https://doi.org/10.1097/NHH.000000000000048
  • Guerin K, Wagner J, Rains K, Bessesen M. (2010). Reduction in central line-associated bloodstream infections by implementation of a postinsertion care bundle. American Journal of Infection Control, 38, 430-433. https://doi.org/10.1016/j.ajic.2010.03.007
  • Havan M, Özcan S, Perk O, Gün E, Kendirli T. (2021). Çocuk yoğun bakımda izlenen hastaların değerlendirilmesi ve mortaliteyi etkileyen faktörler. Çocuk Acil ve Yoğun Bakım Dergisi, 8 (Ek-2), 93-100. https://doi.10.4274/cayd.galenos.2020.72602
  • Isgüder R, Gülfidan G, Agın H, Devrim I, Karaarslan U, Ünal N. (2014). Central venous catheretization in pediatric intensive care unit: A four-year’s experience. Journal of Pediatrics Emergency Intensive Care Medicine, 10, 31-38.
  • Kendirli T, Yaman A, Ödek Ç, Özdemir H, Karbuz A, Aldemir B, Güriz H, Ateş C, Özsoy G, Aysev D, Çifti D, İnce E. (2017). Central line-associated bloodstream infections in pediatric intensive care unit. Cocuk Acil ve Yoğun Bakım, 4(2), 42. https://doi.10.4274/cayd.86580
  • Kıray S, Yıldırım D, Özçiftçi S, Korhan A, Uyar M. (2019). Santral venöz kateter bakımı ve enfeksiyon: Bir sistematik derleme. Turkish Journal of Intensive Care, 17(2), 60-74. https://doi.10.4274/tybd.galenos.2019.02418
  • Kurt B. (2018). Santral venöz kateter enfeksiyonlarını önlemeye yönelik hemşirelik uygulamaları. Adnan Menderes Üniversitesi Sağlık Bilimleri Fakültesi Dergisi, 2(3), 21-27.
  • Kuş B, Büyükyılmaz F. (2019). Periferik intravenöz kateter uygulamalarında güncel kılavuz önerileri. Gümüşhane Üniversitesi Sağlık Bilimleri Fakültesi Dergisi, 8(3), 326-332.
  • Lou BH, Wang LH, Chen Y. (2017). A meta-analysis of efficacy and safety of catheter-directed interventions in submassive pulmonary embolism. European Review for Medical and Pharmacological Sciences, 21(1), 184-198.
  • Mehndiratta MM, Nayak R, Ali S, Sharma A. (2016). Bloodstream infections in NNICU: Blight on ICU stay. Annals of Indian Academy of Neurology, 19(3), 327-331.
  • O'Grady NP, Alexander M, Burns LA, Dellinger EP, Garland J, Heard SO, Pamela A, Masur H, Mermek LA, Pearson ML, Raad II, Randolph AG, Rupp ME, Sait S. (2011). Guidelines for the prevention of intravascular catheter-related infections. Clinical Infectious Diseases, 52(9), 162-193. https://doi.org/10.1093/cid/cir257
  • O’Neil C, Ball K, Wood H, McMullen K, Kremer P, Jafarzadeh SR, Fraser V, Warren D. (2016). A central line care maintenance bundle for the prevention of central line–associated bloodstream infection in non–intensive care unit settings. Infection Control & Hospital Epidemiology, 37(6), 692-698. https://doi.org/10.1542/peds.110.5.e51
  • Ovayolu N, Coşkun Güner İ, Karadağ G. (2006). Santral venöz kateter (SVK) uygulanan hastalarda uygulama öncesi ve sonrası alınan önlemlerin belirlenmesi. Atatürk Universitesi Hemşirelik Dergisi, 9(3), 26-35.
  • Öcal D, Dolapçı İ. (2012). Santral venöz kateter ile ilişkili enfeksiyonlar. Türk Mikrobiyoloji Cemiyeti Dergisi, 42, 1-9. https://doi.org/10.5222/TMCD.2012.001
  • Purvis S, Gion T, Kennedy G, Rees S, Safdar N, VanDenBergh S, Jessica W. (2014). Catheter associated urinary tract infection. Journal of Nursing Care Quality, 29(2), 141-148. https://doi.org/10.1097/NCQ.0000000000000037
  • Sheridan RL, Weber JM. (2006). Mechanical and infectious complications of central venous cannulation in children: Lessons learned from a 10-year experience placing more than 1000 catheters. Journal of Burn Care & Research, 27(5), 713-718. https://doi.org/10.1097/01.BCR.0000238087.12064.E0
  • Tünger Ö, Tireli M. (2013). Intravenöz kateter infeksiyonları: Sorunlar ve çözümler. Ankem Dergisi, 27(2), 96-105. https://doi.org/10.5222/ankem.2013. 096
  • Yazıcı N, Akyüz C, Yalçın B, Varan A, Kutluk T, Büyükpamukçu M. (2016). Infectious complications and conservative treatment of totally implantable venous access devices in children with cancer. Turkish Journal of Pediatrics, 55, 164-171.

Pediatrik Kardiyovasküler Cerrahi Yoğun Bakım Ünitesinde Santral Venöz Kateter Uygulamalarına İlişkin Enfeksiyon Gelişimi ve Nedenlerinin İncelenmesi: Retrospektif Çalışma

Year 2023, Volume: 6 Issue: 2, 265 - 272, 01.09.2023

İrem Habibe Taşdelen Türkinaz Aştı Funda Büyükyılmaz

https://doi.org/10.38108/ouhcd.1012803

Abstract

Amaç: Bu araştırma, pediatrik kardiyovasküler cerrahi yoğun bakım ünitesinde tedavi gören hastaların santral venöz kateter (SVK) uygulamalarındaki enfeksiyon gelişimi durumları ve nedenlerinin değerlendirilmesi amacıyla gerçekleştirildi.
Yöntem: Retrospektif-kesitsel olarak gerçekleştirilen araştırmanın evrenini, özel bir hastanede pediatrik kardiyovasküler yoğun bakım ünitesinde tedavi ve izlem amacıyla takip edilen 317 hasta verisi oluşturdu. Örneklemini ise, evren içindeki hastalardan SVK uygulanan hastaların verileri oluşturdu (n=70). Araştırmanın verileri, kurum arşivinden temin edilen hasta dosyaları taranarak elde edildi. Araştırmada elde edilen veriler, bilgisayarda istatistiksel olarak analiz edildi. İstatistik anlamlılık düzeyi p<0.05 olarak kabul edildi.
Bulgular: Araştırma kapsamındaki hastaların 2.21±1.14 aylık olduğu belirlendi. Hastaların çoğunluğunun (%57.1) siyanotik kalp hastalığı nedeni ile ameliyat olduğu, ortalama 1.37±0.48 gündür yoğun bakımda tedavi gördüğü ve SVK kalış süresinin ortalama 1.54±0.50 gün olduğu belirlendi. Hastaların %37.1’inin SVK giriş bölgesinde ve %44.3’ünde genel (sistemik) enfeksiyon belirti-bulgusunun olduğu belirlendi. Yoğun bakımda yatış süresi 1-5 gün olan hastalarda kateter giriş yerinde enfeksiyon görülme sıklığının yüksek olduğu belirlendi. Ayrıca kateter kalış süresi 6-10 gün olan hastaların enfeksiyon olasılığının da 7.15 kat fazla olduğu belirlendi (p<0.05).
Sonuç: Pediatrik kardiyovasküler yoğun bakımda yatış süresi (1-5 gün) ve kateter kalış süresinin (6 gün ve üzeri), kateter giriş yerinde enfeksiyon görülme sıklığını ve olasılığını arttırdığı sonucuna varıldı.

Keywords

Santral venöz kateter hemşirelik bakımı enfeksiyon pediatri yoğun bakım

References

  • Abedin S, Kapoor G. (2008). Peripherally inserted central venous catheters are a good option for prolonged venous access in children with cancer. Pediatric Blood Cancer, 51, 251-255. https://doi.org/10.1002/pbc.21 344. Centers for Disease Control and Prevention (CDC)https://www.cdc.gov/ 2011 Guidelines for the Prevention of Intravascular Catheter Related Infections. Erişim tarihi:10.01.2019, https://www.cdc.gov/infectioncontrol/guidelines/bsi/recommendations.html
  • Çıtak A, Karaböcüoğlu M, Üçsel R, Uzel N. (2002). Central venous catheters in pediatric patients-subclavian venous approach as the first choice. Pediatrics International, 44, 83-86. https://doi.org/10.1046/j.1442-200X.2002.01509.x
  • Fadoo Z, Nisar MI, Iftikhar R, Ali S, Mushtaq N, Sayani R. (2015). Peripherally inserted central venous catheters in pediatric hematology/oncology patients in tertiary care setting: A developing country experience. Journal of Pediatric Hematological Oncology, 37, 421-423. https://doi.org/10.1097/MPH.000000000 0000369
  • Gerçeker G, Yardımcı F, Aydınok Y. (2017). Randomized controlled trial of care bundles with chlorhexidine dressing and advanced dressing to prevent catheter related bloodstream infections in pediatric hematology-oncolohy patients. European Journal of Oncology Nursing, 28, 14-20. https://doi.org/10.1016/j.ejon.2017.02.008
  • Gorski LA. (2017). The 2016 infusion therapy standards of practice. Home Healthcare Now, 35, 10-18. https://doi.org/10.1097/NHH.000000000000048
  • Guerin K, Wagner J, Rains K, Bessesen M. (2010). Reduction in central line-associated bloodstream infections by implementation of a postinsertion care bundle. American Journal of Infection Control, 38, 430-433. https://doi.org/10.1016/j.ajic.2010.03.007
  • Havan M, Özcan S, Perk O, Gün E, Kendirli T. (2021). Çocuk yoğun bakımda izlenen hastaların değerlendirilmesi ve mortaliteyi etkileyen faktörler. Çocuk Acil ve Yoğun Bakım Dergisi, 8 (Ek-2), 93-100. https://doi.10.4274/cayd.galenos.2020.72602
  • Isgüder R, Gülfidan G, Agın H, Devrim I, Karaarslan U, Ünal N. (2014). Central venous catheretization in pediatric intensive care unit: A four-year’s experience. Journal of Pediatrics Emergency Intensive Care Medicine, 10, 31-38.
  • Kendirli T, Yaman A, Ödek Ç, Özdemir H, Karbuz A, Aldemir B, Güriz H, Ateş C, Özsoy G, Aysev D, Çifti D, İnce E. (2017). Central line-associated bloodstream infections in pediatric intensive care unit. Cocuk Acil ve Yoğun Bakım, 4(2), 42. https://doi.10.4274/cayd.86580
  • Kıray S, Yıldırım D, Özçiftçi S, Korhan A, Uyar M. (2019). Santral venöz kateter bakımı ve enfeksiyon: Bir sistematik derleme. Turkish Journal of Intensive Care, 17(2), 60-74. https://doi.10.4274/tybd.galenos.2019.02418
  • Kurt B. (2018). Santral venöz kateter enfeksiyonlarını önlemeye yönelik hemşirelik uygulamaları. Adnan Menderes Üniversitesi Sağlık Bilimleri Fakültesi Dergisi, 2(3), 21-27.
  • Kuş B, Büyükyılmaz F. (2019). Periferik intravenöz kateter uygulamalarında güncel kılavuz önerileri. Gümüşhane Üniversitesi Sağlık Bilimleri Fakültesi Dergisi, 8(3), 326-332.
  • Lou BH, Wang LH, Chen Y. (2017). A meta-analysis of efficacy and safety of catheter-directed interventions in submassive pulmonary embolism. European Review for Medical and Pharmacological Sciences, 21(1), 184-198.
  • Mehndiratta MM, Nayak R, Ali S, Sharma A. (2016). Bloodstream infections in NNICU: Blight on ICU stay. Annals of Indian Academy of Neurology, 19(3), 327-331.
  • O'Grady NP, Alexander M, Burns LA, Dellinger EP, Garland J, Heard SO, Pamela A, Masur H, Mermek LA, Pearson ML, Raad II, Randolph AG, Rupp ME, Sait S. (2011). Guidelines for the prevention of intravascular catheter-related infections. Clinical Infectious Diseases, 52(9), 162-193. https://doi.org/10.1093/cid/cir257
  • O’Neil C, Ball K, Wood H, McMullen K, Kremer P, Jafarzadeh SR, Fraser V, Warren D. (2016). A central line care maintenance bundle for the prevention of central line–associated bloodstream infection in non–intensive care unit settings. Infection Control & Hospital Epidemiology, 37(6), 692-698. https://doi.org/10.1542/peds.110.5.e51
  • Ovayolu N, Coşkun Güner İ, Karadağ G. (2006). Santral venöz kateter (SVK) uygulanan hastalarda uygulama öncesi ve sonrası alınan önlemlerin belirlenmesi. Atatürk Universitesi Hemşirelik Dergisi, 9(3), 26-35.
  • Öcal D, Dolapçı İ. (2012). Santral venöz kateter ile ilişkili enfeksiyonlar. Türk Mikrobiyoloji Cemiyeti Dergisi, 42, 1-9. https://doi.org/10.5222/TMCD.2012.001
  • Purvis S, Gion T, Kennedy G, Rees S, Safdar N, VanDenBergh S, Jessica W. (2014). Catheter associated urinary tract infection. Journal of Nursing Care Quality, 29(2), 141-148. https://doi.org/10.1097/NCQ.0000000000000037
  • Sheridan RL, Weber JM. (2006). Mechanical and infectious complications of central venous cannulation in children: Lessons learned from a 10-year experience placing more than 1000 catheters. Journal of Burn Care & Research, 27(5), 713-718. https://doi.org/10.1097/01.BCR.0000238087.12064.E0
  • Tünger Ö, Tireli M. (2013). Intravenöz kateter infeksiyonları: Sorunlar ve çözümler. Ankem Dergisi, 27(2), 96-105. https://doi.org/10.5222/ankem.2013. 096
  • Yazıcı N, Akyüz C, Yalçın B, Varan A, Kutluk T, Büyükpamukçu M. (2016). Infectious complications and conservative treatment of totally implantable venous access devices in children with cancer. Turkish Journal of Pediatrics, 55, 164-171.
There are 22 citations in total.

Details

Primary Language Turkish
Subjects Nursing
Journal Section Araştırma
Authors

İrem Habibe Taşdelen 0000-0001-7855-4079

Türkinaz Aştı This is me 0000-0002-9127-7798

Funda Büyükyılmaz 0000-0002-7958-4031

Early Pub Date September 1, 2023
Publication Date September 1, 2023
Submission Date February 10, 2022
Published in Issue Year 2023 Volume: 6 Issue: 2

Cite

APA Taşdelen, İ. H., Aştı, T., & Büyükyılmaz, F. (2023). Pediatrik Kardiyovasküler Cerrahi Yoğun Bakım Ünitesinde Santral Venöz Kateter Uygulamalarına İlişkin Enfeksiyon Gelişimi ve Nedenlerinin İncelenmesi: Retrospektif Çalışma. Ordu Üniversitesi Hemşirelik Çalışmaları Dergisi, 6(2), 265-272. https://doi.org/10.38108/ouhcd.1012803
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