Skip to main content
Hauptrubriken
CME Facharzt-Training Webinare Zeitschriften Bücher e.Medpedia Podcast
Service
Jobbörse Info & Hilfe
Fachgebiete
Anästhesiologie Allgemeinmedizin Arbeitsmedizin Augenheilkunde Chirurgie Dermatologie Gynäkologie und Geburtshilfe HNO Innere Medizin Kardiologie Neurologie Onkologie und Hämatologie Orthopädie und Unfallchirurgie Pädiatrie Pathologie Psychiatrie Radiologie Rechtsmedizin Urologie Zahnmedizin
Themen
Klimawandel und Gesundheit Neues aus dem Markt COVID-19 Praxis und Beruf Seltene Erkrankungen GOÄ & EBM Panorama
Sammlungen
Kasuistiken Algorithmen & Infografiken Blickdiagnosen Arthropedia FlapFinder (für Dermatochirurgen) Videos Kongressberichterstattung Medizin für Apothekerinnen und Apotheker Für Ärztinnen und Ärzte in Weiterbildung Für Medizinstudierende
Erweiterte Suche
Anmelden
nach oben
Intensive Care Medicine
Erschienen in: Intensive Care Medicine 8/2013

01.08.2013 | Review

Are central line bundles and ventilator bundles effective in critically ill neonates and children?

verfasst von: Charlotte A. Smulders, Josephus P. J. van Gestel, Albert P. Bos

Erschienen in: Intensive Care Medicine | Ausgabe 8/2013

Einloggen, um Zugang zu erhalten

Abstract

Central line-associated bloodstream infections (CLABSI) and ventilator-associated pneumonia (VAP) are common problems in adult, pediatric (PICU) and neonatal (NICU) intensive care unit patients. Care bundles have been developed to prevent these hospital-acquired infections and to provide best possible care. Studies in adults have proven that care bundles contribute to a decrease in CLABSI and VAP rates. The purpose of this literature review was to critically appraise the known evidence of the effectiveness of central line bundles and ventilator bundles in PICU and NICU patients. The number of publications of central line bundles and ventilator bundles in PICU and NICU patients is limited compared to adults. Ten studies in PICU patients demonstrated a significant decrease in the CLABSI or VAP rate after implementation of the bundle. Two studies in neonates demonstrated a reduction in the CLABSI rate after implementation of the central line bundle. No studies on the effectiveness of the ventilator bundle in neonates were found. Bundle elements differed between studies, and their scientific basis was not as robust as in adults. Monitoring of compliance to bundle elements seems required for optimal reduction of CLABSI and VAP. Bundle components that focus on maintenance of a central line probably are important to prevent CLABSI in children.
Literatur
1.
2.
Grohskopf LA, Sinkowitz-Cochran RL, Garrett DO, Sohn AH, Levine GL, Siegel JD et al (2002) A national point-prevalence survey of pediatric intensive care unit—acquired infections in the United States. J Pediatr 140:432–438PubMedCrossRef
3.
Richards MJ, Edwards JR, Culver DH, Gaynes RP (1999) Nosocomial infections in pediatric intensive care units in the United States. National Nosocomial Infections Surveillance System. Pediatrics 103:e39PubMedCrossRef
4.
Edwards JR, Peterson KD, Andrus ML et al (2007) National Healthcare Safety Network (NHSN) Report, data summary for 2006, issued June 2007. Am J Infect Control 35:290–301PubMedCrossRef
5.
O’Grady NP, Alexander M, Burns LA et al (2011) Guidelines for the prevention of intravascular catheter-related infections. Clin Infect Dis 52:e162–e193PubMedCrossRef
6.
Tablan OC, Anderson LJ, Besser R, Bridges C, Hajjeh R, CDC, Healthcare Infection Control Practices Advisory Committee (2004) Guidelines for preventing health-care-associated pneumonia, 2003: recommendations of CDC and the Healthcare Infection Control Practices Advisory Committee. MMWR Recomm Rep 53((RR-3)):1–36PubMed
7.
Jarvis W, Edwards JR, Culver GH et al (1991) Nosocomial infection rates in adult and pediatric intensive care units in the United States. National Nosocomial Infections Surveillance System. Am J Med 91:185s–191sPubMedCrossRef
8.
Venkatachalam V, Hendley JO, Wilson DF (2011) The diagnostic dilemma of ventilator-associated pneumonia in critically ill children. Pediatr Crit Care Med 12:286–296PubMedCrossRef
9.
10.
Slonim AD, Kurtines HC, Sprague BM, Singh N (2001) The costs associated with nosocomial bloodstream infections in the pediatric intensive care unit. Pediatr Crit Care Med 2:170–174PubMedCrossRef
11.
Bhutta A, Gilliam C, Honeycutt M et al (2007) Reduction of bloodstream infections associated with catheters in paediatric intensive care unit: stepwise approach. BMJ 334:362–365PubMedCrossRef
12.
Li S, Bizzarro MJ (2011) Prevention of central line associated bloodstream infections in critical care units. Curr Opin Pediatr 23:85–90PubMedCrossRef
13.
Elward AM, Hollenbeak CS, Warren DK, Fraser VJ (2005) Attributable cost of nosocomial primary bloodstream infection in pediatric intensive care unit patients. Pediatrics 115:868–872PubMedCrossRef
14.
Powers RJ, Wirtschafter DW (2010) Decreasing central line associated bloodstream infection in neonatal intensive care. Clin Perinatol 37:247–272PubMedCrossRef
15.
Klevens RM, Edwards JR, Richards CL et al (2007) Estimating health care-associated infections and death in US hospitals, 2002. Public Health Rep 122:160–166PubMed
16.
17.
Morris AC, Hay AW, Swann DG et al (2011) Reducing ventilator-associated pneumonia in intensive care: impact of implementing a care bundle. Crit Care Med 39:2218–2224PubMedCrossRef
18.
Lachman P, Yuen S (2009) Using care bundles to prevent infection in neonatal and paediatric ICUs. Curr Opin Infect Dis 22:224–228PubMedCrossRef
19.
Winters B, Dorman T (2006) Patient-safety and quality initiatives in the intensive-care unit. Curr Opin Anaesthesiol 19:140–145PubMedCrossRef
20.
Shuman EK, Washer LL, Arndt JL et al (2010) Analysis of central line-associated bloodstream infections in the intensive care unit after implementation of central line bundles. Infect Control Hosp Epidemiol 31:551–553PubMedCrossRef
21.
Pronovost P, Needham D, Bernholtz S et al (2006) An intervention to decrease catheter-related bloodstream infections in the ICU. N Engl J Med 355:2725–2732PubMedCrossRef
22.
Bonello RS, Fletcher CE, Becker WK et al (2008) An intensive care unit quality improvement collaborative in nine Department of Veterans Affairs hospitals: reducing ventilator-associated pneumonia and catheter-related bloodstream infection rates. Jt Comm J Qual Patient Saf 34:639–645PubMed
23.
Furuya EY, Dick A, Perencevich EN, Pogorzelska M, Goldmann D, Stone PW (2011) Central line bundle implementation in US intensive care units and impact on bloodstream infections. PLoS One 6:e15452PubMedCrossRef
24.
Galpern D, Guerrero A, Tu A, Fahoum B, Wise L (2008) Effectiveness of a central line bundle campaign on line-associated infections in the intensive care unit. Surgery 144:492–495PubMedCrossRef
25.
Venkatram S, Rachmale S, Kanna B (2010) Study of device use adjusted rates in health care-associated infections after implementation of “bundles” in a closed-model medical intensive care unit. J Crit Care 25:174.e11–174.e18CrossRef
26.
Wip C, Napolitano L (2009) Bundles to prevent ventilator-associated pneumonia: how valuable are they? Curr Opin Infect Dis 22:159–166PubMedCrossRef
27.
National Nosocomial Infections Surveillance System (2004) National Nosocomial Infections Surveillance System (NNIS) system report, data summary from January 1992 through June 2004, issued October 2004. Am J Infect Control 32:470–485CrossRef
28.
Huskins WC (2012) Quality improvement interventions to prevent healthcare-associated infections in neonates and children. Curr Opin Pediatr 24:103–112PubMedCrossRef
29.
Bizzarro MJ, Sabo B, Noonan M et al (2010) A quality improvement initiative to reduce central line-associated bloodstream infections in a neonatal intensive care unit. Infect Control Hosp Epidemiol 31:241–248PubMedCrossRef
30.
Schulman J, Stricof R, Stevens TP et al (2011) Statewide NICU central-line-associated bloodstream infection rates decline after bundles and checklists. Pediatrics 127:436–444PubMedCrossRef
31.
Costello JM, Morrow DF, Graham DA, Potter-Bynoe G, Sandora TJ, Laussen PC (2008) Systematic intervention to reduce central line-associated bloodstream infection rates in a pediatric cardiac intensive care unit. Pediatrics 121:915–923PubMedCrossRef
32.
Jeffries HE, Mason W, Brewer M et al (2009) Prevention of central venous catheter-associated bloodstream infections in pediatric intensive care units: a performance improvement collaborative. Infect Control Hosp Epidemiol 30:645–651PubMedCrossRef
33.
McKee C, Berkowitz I, Cosgrove SE et al (2008) Reduction of catheter-associated bloodstream infections in pediatric patients: experimentation and reality. Pediatr Crit Care Med 9:40–46PubMedCrossRef
34.
Miller MR, Niedner MF, Huskins WC et al (2011) Reducing PICU central line-associated bloodstream infections: 3-year results. Pediatrics 128:e1077–e1083PubMedCrossRef
35.
Miller-Hoover S (2011) Pediatric central line: bundle implementation and outcomes. J Infus Nurs 34:36–48PubMedCrossRef
36.
Morgan LM, Thomas DJ (2007) Implementing evidence-based nursing practice in the pediatric intensive care unit. J Infus Nurs 30:105–112PubMedCrossRef
37.
Wheeler DS, Giaccone MJ, Hutchinson N et al (2011) A hospital-wide quality-improvement collaborative to reduce catheter-associated bloodstream infections. Pediatrics 128:e995–e1004PubMedCrossRef
38.
Bigham MT, Amato R, Bondurrant P et al (2009) Ventilator-associated pneumonia in the pediatric intensive care unit: characterizing the problem and implementing a sustainable solution. J Pediatr 154:582–587PubMedCrossRef
39.
Brierley J, Highe L, Hines S, Dixon G (2012) Reducing VAP by instituting a care bundle using improvement methodology in a UK paediatric intensive care unit. Eur J Pediatr 171:323–330PubMedCrossRef
40.
Brilli RJ, Sparling KW, Lake MR et al (2008) The business case for preventing ventilator-associated pneumonia in pediatric intensive care unit patients. Jt Comm J Qual Patient Saf 34:629–638PubMed
41.
Chittick P, Sherertz RJ (2010) Recognition and prevention of nosocomial vascular device and related bloodstream infections in the intensive care unit. Crit Care Med 38(8 Suppl):363–372CrossRef
42.
Marwick C, Davey P (2009) Care bundles: the holy grail of infectious risk management in hospital? Curr Opin Infect Dis 22:364–369PubMedCrossRef
43.
Miller MR, Griswold M, Harris JM et al (2010) Decreasing PICU catheter-associated bloodstream infections: NACHRI’s quality transformation efforts. Pediatrics 125:206–213PubMedCrossRef
44.
Kilo CM, Kabcenell RN, Berwick DM (1998) Beyond survival: toward continuous improvement in medical care. New Horiz 6:3–11PubMed
Metadaten
Titel
Are central line bundles and ventilator bundles effective in critically ill neonates and children?
verfasst von
Charlotte A. Smulders
Josephus P. J. van Gestel
Albert P. Bos
Publikationsdatum
01.08.2013
Verlag
Springer Berlin Heidelberg
Erschienen in
Intensive Care Medicine / Ausgabe 8/2013
Print ISSN: 0342-4642
Elektronische ISSN: 1432-1238
DOI
https://doi.org/10.1007/s00134-013-2927-7

Weitere Artikel der Ausgabe 8/2013

Intensive Care Medicine 8/2013 Zur Ausgabe

Original: Postoperative Critical Care

Long-term mortality in patients with chronic obstructive pulmonary disease following extracorporeal membrane oxygenation for cardiac assist after cardiovascular surgery

Original

Decreased respiratory rate variability during mechanical ventilation is associated with increased mortality

Editorial

Research to inform the consent-to-research process

Editorial

‘In plain language’: uniform criteria for organ donor recognition

Correspondence

Precautions with heated humidifier systems in particular environments

Original

Quality of reporting of randomized controlled trials published in Intensive Care Medicine from 2001 to 2010

Neu im Fachgebiet AINS

Sind Frauen die fähigeren Ärzte?

30.04.2024 Gendermedizin Nachrichten

Patienten, die von Ärztinnen behandelt werden, dürfen offenbar auf bessere Therapieergebnisse hoffen als Patienten von Ärzten. Besonders gilt das offenbar für weibliche Kranke, wie eine Studie zeigt.

Akuter Schwindel: Wann lohnt sich eine MRT?

28.04.2024 Schwindel Nachrichten

Akuter Schwindel stellt oft eine diagnostische Herausforderung dar. Wie nützlich dabei eine MRT ist, hat eine Studie aus Finnland untersucht. Immerhin einer von sechs Patienten wurde mit akutem ischämischem Schlaganfall diagnostiziert.

Bei schweren Reaktionen auf Insektenstiche empfiehlt sich eine spezifische Immuntherapie

25.04.2024 Allergien und Intoleranzreaktionen Nachrichten

Insektenstiche sind bei Erwachsenen die häufigsten Auslöser einer Anaphylaxie. Einen wirksamen Schutz vor schweren anaphylaktischen Reaktionen bietet die allergenspezifische Immuntherapie. Jedoch kommt sie noch viel zu selten zum Einsatz.

Hinter dieser Appendizitis steckte ein Erreger

23.04.2024 Appendizitis Nachrichten

Schmerzen im Unterbauch, aber sonst nicht viel, was auf eine Appendizitis hindeutete: Ein junger Mann hatte Glück, dass trotzdem eine Laparoskopie mit Appendektomie durchgeführt und der Wurmfortsatz histologisch untersucht wurde.

Update AINS

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

hier abonnieren
Bildnachweise