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Catheter‐related sepsis in ultrasound‐guided percutaneously inserted long‐term tunnelled central venous catheter: A review of 50 patients
Author(s) -
Li WingHong,
Tsang ShiuHei,
Tsao Joanne PuiYue,
Tong WaiChung,
Tang LapFai
Publication year - 2005
Publication title -
surgical practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.109
H-Index - 10
eISSN - 1744-1633
pISSN - 1744-1625
DOI - 10.1111/j.1744-1633.2005.00253.x
Subject(s) - medicine , catheter , sepsis , percutaneous , surgery , complication , central venous catheter , incidence (geometry) , ultrasound , radiology , physics , optics
Objective: Ultrasound‐guided percutaneous insertion of a long‐term tunneled central venous catheter (TCVC) is now a very common procedure, but catheter‐related sepsis remains a significant problem. This study aims to review our results concerning this complication. Methodology: Fifty‐seven central venous catheters were inserted into 50 patients percutaneously under ultrasound guidance in Queen Elizabeth hospital for between 1 March 2003 and 30 April 2004. Data was retrospectively collected and analysed from hospital records. Results: This study had a successful placement rate of 100%. The overall complication rate was 31% (18 out of 57), comprised of four mechanical complications (all occurring within 30 days of insertion). There was no complication documented within the first 24 h. Fourteen patients developed infective complications, and of these eight patients were classified as catheter‐related sepsis, all requiring premature removal of their catheters. There were in total 6161 catheter days, with the incidence rate of catheter‐related sepsis of 1.2 per 1000 catheter days. The infecting organisms were heterogeneous, with the majority being Gram‐positive cocci (47%). Our study found that patients who developed neutropaenia within 30 days after insertion were significantly associated with catheter‐related sepsis ( P < 0.05). Conclusion: Insertion of TCVC under ultrasound guidance is a safe method with a high success rate. Incidence of catheter‐related sepsis of TCVC under percutaneous guidance was comparable to the open method. Neutropaenia developing within 30 days after ultrasound‐guided percutaneous insertion of central venous catheter may be associated with increased risk of catheter‐related sepsis.