Arterial catheter outcomes in intensive care: An analysis of 1117 patients

IF 2.7 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Infection Disease & Health Pub Date : 2025-02-01 DOI:10.1016/j.idh.2024.07.006

Samantha Keogh , Emily Larsen , Amanda Corley , Mari Takashima , Nicole Marsh , Melannie Edwards , Heather Reynolds , Jayesh Dhanani , Fiona Coyer , Kevin B. Laupland , Claire M. Rickard

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引用次数: 0

Abstract

Background

Access to arterial circulation through arterial catheters (ACs) is crucial for monitoring and decision-making in intensive care units (ICU) but carries the risk of complications including bloodstream infection (BSI).

Methods

We conducted a secondary analysis of data from four randomised controlled trials in Australian ICUs, investigating the efficacy of different AC interventions. De-identified data were combined into a single dataset, and per-patient outcomes analysed. The primary outcome was AC-BSI, defined as laboratory confirmed bloodstream infection (LCBI) type 1 or 2, with a concurrent local infection. All-cause AC failure was defined as any unplanned removal. AC infection and failure were reported as rates per 1000 catheter days and hours.

Results

Data from 1117 adult patients were analysed. Mean age was 58.8 years (±16.6); and 41% (n = 462) were male. Median AC dwell time was 110 h (IQR 28.3–168.0). There was one case (<0.1%; 0.18/1000 catheter days [95% CI 0.03–1.29]) of AC-BSI, and 14 cases of LCBI (1%; 13 LCBI-1 and 1 LCBI-2; 2.54/1000 catheter days [95% CI 1.51–4.30]). LCBI were most commonly Enterococcus faecalis; Escherichia coli and Klebsiella pneumoniae. There were four cases of local infection (<1%; 0.73/1000 catheter days [95% CI 0.27–1.94]). Overall AC failure rate was 13% (n = 146) or 26.53/1000 catheter days (95% CI 22.56–31.20).

Conclusion

This study identified a relatively low incidence of complications. This is likely reflective of poor monitoring of ACs in intensive care. Better surveillance and a rigorous prospective evaluation of AC outcomes is required to understand the true risk ACs pose to critically ill patients.

查看原文本刊更多论文

重症监护中动脉导管的效果：对 1117 名患者的分析。

背景：通过动脉导管（AC）进入动脉循环对重症监护病房（ICU）的监测和决策至关重要，但也存在包括血流感染（BSI）在内的并发症风险：我们对澳大利亚重症监护病房的四项随机对照试验数据进行了二次分析，研究了不同 AC 干预措施的疗效。去身份化数据合并成一个数据集，并对每位患者的结果进行分析。主要结果是 AC-BSI，定义为实验室确诊的 1 型或 2 型血流感染（LCBI），同时伴有局部感染。全因 AC 失败定义为任何非计划性切除。导管感染率和失败率以每 1000 个导管天数和小时数为单位进行报告：结果：分析了 1117 名成年患者的数据。平均年龄为 58.8 岁 (±16.6)；男性占 41% (n = 462)。中位 AC 停留时间为 110 小时（IQR 28.3-168.0）。有一个病例（结论：这项研究发现并发症的发生率相对较低。这可能反映出重症监护中对空调的监控不力。要了解空调对重症患者造成的真正风险，需要对空调的结果进行更好的监控和严格的前瞻性评估。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Infection Disease & Health PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-

CiteScore

5.70

自引率

5.70%

发文量

审稿时长

20 days

期刊介绍： The journal aims to be a platform for the publication and dissemination of knowledge in the area of infection and disease causing infection in humans. The journal is quarterly and publishes research, reviews, concise communications, commentary and other articles concerned with infection and disease affecting the health of an individual, organisation or population. The original and important articles in the journal investigate, report or discuss infection prevention and control; clinical, social, epidemiological or public health aspects of infectious disease; policy and planning for the control of infections; zoonoses; and vaccination related to disease in human health. Infection, Disease & Health provides a platform for the publication and dissemination of original knowledge at the nexus of the areas infection, Disease and health in a One Health context. One Health recognizes that the health of people is connected to the health of animals and the environment. One Health encourages and advances the collaborative efforts of multiple disciplines-working locally, nationally, and globally-to achieve the best health for people, animals, and our environment. This approach is fundamental because 6 out of every 10 infectious diseases in humans are zoonotic, or spread from animals. We would be expected to report or discuss infection prevention and control; clinical, social, epidemiological or public health aspects of infectious disease; policy and planning for the control of infections; zoonosis; and vaccination related to disease in human health. The Journal seeks to bring together knowledge from all specialties involved in infection research and clinical practice, and present the best work in this ever-changing field. The audience of the journal includes researchers, clinicians, health workers and public policy professionals concerned with infection, disease and health.