Brief CommunicationAssociation between thrombosis and bloodstream infection in neonates with peripherally inserted catheters
Section snippets
Materials and methods
We performed a retrospective cohort study of the 1540 PICs placed in 882 infants from August 2002 until November 2005 in the DUMC NICU. A CABSI was defined as a positive blood culture which was documented > 24 h after PIC placement or within 72 h of catheter removal. Positive cultures were ignored if the same organism was cultured in the week prior to catheter insertion. Evidence of thrombus included cord, phlebitis, extremity edema, extremity perfusion, and inability to draw or flush the
Results
We analyzed 1540 PIC insertions in 882 infants. Baseline characteristics are shown in Table 1. The majority of PICs were placed in the arm (N = 572), foot (N = 488) and hand (N = 326). Other locations included leg, scalp, axilla, neck and groin veins. The most common reasons for catheter insertion included general intravenous access, nutrition, and antibiotics. Reasons for PIC removal were available for 1428 PICs (Table 2). Two hundred eighteen PICs were still in place at the time infants were
Discussion
In this retrospective study we found a thrombosis rate of 13.2/1000 catheter days, and evidence that there is a positive association between catheter thrombosis and infection. Of interest, the occurrence of both infection and thrombosis decreased over time. The parallel decrease also supports the hypothesis of an association between CABSI and thrombosis. The risk of thrombosis was not associated with catheter site. We would expect a higher rate of both infection and thrombosis in younger
Acknowledgement
The authors wish to thank the nurses in the DUMC NICU who provide care for the infants and to Katie Cheng and Rose Guo who participated in data entry as students at the North Carolina School of Math and Science.
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