Mol van Otterloo, E. de (Eliane) (2021) Selecting the superior initial lifeline: In neonates with gastroschisis and intestinal atresia. thesis, Medicine.
Full text available on request.Abstract
Background. Paediatric patients with gastroschisis and/or intestinal atresia are dependent on long-term parental nutrition (PN). However, selecting the superior type of initial inserted central venous catheter (CVC) for the administration of these fluids remains ambiguous. Methods. In this retrospective study, we compared the complication rates of central line�associated bloodstream infections (CLABSI) or catheter-related thrombosis (CRT) between initial placed Broviacs® and PICCs, and between Broviacs® and Arrows®. Additionally, we analysed independent risk factors associated with the development of these complications using a Wald’s logistic regression model. Results. We included 151 Broviacs®, 29 PICCs and 13 Arrows® as initial CVC. Although complication rates were not significant different between Broviacs® and PICCs (10.95 vs 22.84/1000 catheter days, p = .74), Broviacs® had less CVC-related complications leading to removal (22% vs 69%, p = <.001). Arrows® were associated with an increased complication rate and risk (54,79 vs 10.95/1000 catheter days, odds ratio [OR] 4.27, 95% CI 1.29 – 14.12). The duration of CVC insertion was identified as an independent risk factor for the occurrence of CLABSI or CRT (OR 1.1, 95% CI 1.01 – 1.21). Conclusion. As all patients in this specific population inevitably require surgery, we suggest the placement of Broviac® catheters as the initial inserted CVC during abdominal surgery. If prior PN-therapy is needed, we advise the insertion of a PICC as initial catheter, thereby avoiding the disadvantages of general anaesthesia. The calculated risk per week of developing a CLABSI or CRT associated with the indwelling catheter may be used as a tool for clinicians.
| Item Type: | Thesis (UNSPECIFIED) |
|---|---|
| Supervisor name: | Eeftinck Schattenkerk, L. and Bekhof, dr. J. |
| Faculty: | Medical Sciences |
| Date Deposited: | 06 Jan 2022 11:20 |
| Last Modified: | 06 Jan 2022 11:20 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/2971 |
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