Risk of catheter-associated infection in young hematology/oncology patients receiving long-term peripheral nerve blocks
Continuous peripheral nerve blocks (CPNBs) are increasingly used to control postoperative and chronic pain. At our pediatric oncology institution, the duration of CPNBs is often prolonged. The risk of catheter-associated infection with prolonged CPNBs has not been previously investigated. We analyze...
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| Veröffentlicht in: | Pediatric anesthesia 2012-11, Vol.22 (11), p.1110-1116 |
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| creator | Anghelescu, Doralina L. Harris, Brittney L. Faughnan, Lane G. Oakes, Linda L. Windsor, Kelley B. Wright, Becky B. McCullers, Jonathan A. |
| description | Continuous peripheral nerve blocks (CPNBs) are increasingly used to control postoperative and chronic pain. At our pediatric oncology institution, the duration of CPNBs is often prolonged. The risk of catheter-associated infection with prolonged CPNBs has not been previously investigated.
We analyzed the incidence of CPNB-related infection and its relation to catheter duration, catheter site, intensive care stay, and antibiotic coverage.
All CPNBs placed at our institution between August 1, 2005 and October 31, 2010 were studied. Primary diagnosis and the site, indication, duration, and infectious adverse effects of CPNBs were obtained from our Pain Service QI database. Patients' age and sex, antibiotic administration, and number of days in intensive care were collected from patients' medical records.
The use of 179 catheters in 116 patients was evaluated. Mean age at CPNB placement was 15.1 years (median, 14.7; range, 0.4-26.9). The most frequent indication for CPNB was surgery (89.4%), most commonly orthopedic (78.8%). Mean CPNB duration was 7.2 days (median, 5.0; range, 1-81 days). Two cases (1.12%) of CPNBs developed signs of infection, both associated with femoral catheters. The infections were mild and necessitated catheter removal at days 10 and 13, respectively.
Nerve block catheter-associated infections are infrequent at our institution despite prolonged CPNB use. Both patients with infection had femoral catheters and prolonged catheter (≥ 10 days) use. |
| doi_str_mv | 10.1111/j.1460-9592.2012.03880.x |
| format | Article |
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We analyzed the incidence of CPNB-related infection and its relation to catheter duration, catheter site, intensive care stay, and antibiotic coverage.
All CPNBs placed at our institution between August 1, 2005 and October 31, 2010 were studied. Primary diagnosis and the site, indication, duration, and infectious adverse effects of CPNBs were obtained from our Pain Service QI database. Patients' age and sex, antibiotic administration, and number of days in intensive care were collected from patients' medical records.
The use of 179 catheters in 116 patients was evaluated. Mean age at CPNB placement was 15.1 years (median, 14.7; range, 0.4-26.9). The most frequent indication for CPNB was surgery (89.4%), most commonly orthopedic (78.8%). Mean CPNB duration was 7.2 days (median, 5.0; range, 1-81 days). Two cases (1.12%) of CPNBs developed signs of infection, both associated with femoral catheters. The infections were mild and necessitated catheter removal at days 10 and 13, respectively.
Nerve block catheter-associated infections are infrequent at our institution despite prolonged CPNB use. Both patients with infection had femoral catheters and prolonged catheter (≥ 10 days) use.</description><identifier>ISSN: 1155-5645</identifier><identifier>EISSN: 1460-9592</identifier><identifier>DOI: 10.1111/j.1460-9592.2012.03880.x</identifier><identifier>PMID: 22587819</identifier><language>eng</language><publisher>Oxford, UK: Blackwell Publishing Ltd</publisher><subject>Adolescent ; Adult ; Analgesia - instrumentation ; Anti-Bacterial Agents - therapeutic use ; Antibiotics ; Catheter-Related Infections - drug therapy ; Catheter-Related Infections - epidemiology ; Catheters ; Child ; Critical Care - statistics & numerical data ; Female ; Hematology ; Humans ; Incidence ; Infant ; infection ; Infections ; Intensive care ; Length of Stay - statistics & numerical data ; Male ; Medical Oncology ; Nerve Block - instrumentation ; oncology ; pain ; peripheral nerve block ; Peripheral Nerves - drug effects ; Retrospective Studies ; Risk Assessment ; Tennessee - epidemiology ; Time Factors ; Young Adult</subject><ispartof>Pediatric anesthesia, 2012-11, Vol.22 (11), p.1110-1116</ispartof><rights>2012 Blackwell Publishing Ltd.</rights><rights>2012 Blackwell Publishing Ltd</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c519t-8e91d1b228563c8bd3450245fc666826b1243c31a9694ce1586bb0b2e1e069453</citedby><cites>FETCH-LOGICAL-c519t-8e91d1b228563c8bd3450245fc666826b1243c31a9694ce1586bb0b2e1e069453</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,315,782,786,887,27931,27932</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22587819$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Anghelescu, Doralina L.</creatorcontrib><creatorcontrib>Harris, Brittney L.</creatorcontrib><creatorcontrib>Faughnan, Lane G.</creatorcontrib><creatorcontrib>Oakes, Linda L.</creatorcontrib><creatorcontrib>Windsor, Kelley B.</creatorcontrib><creatorcontrib>Wright, Becky B.</creatorcontrib><creatorcontrib>McCullers, Jonathan A.</creatorcontrib><title>Risk of catheter-associated infection in young hematology/oncology patients receiving long-term peripheral nerve blocks</title><title>Pediatric anesthesia</title><addtitle>Paediatr Anaesth</addtitle><description>Continuous peripheral nerve blocks (CPNBs) are increasingly used to control postoperative and chronic pain. At our pediatric oncology institution, the duration of CPNBs is often prolonged. The risk of catheter-associated infection with prolonged CPNBs has not been previously investigated.
We analyzed the incidence of CPNB-related infection and its relation to catheter duration, catheter site, intensive care stay, and antibiotic coverage.
All CPNBs placed at our institution between August 1, 2005 and October 31, 2010 were studied. Primary diagnosis and the site, indication, duration, and infectious adverse effects of CPNBs were obtained from our Pain Service QI database. Patients' age and sex, antibiotic administration, and number of days in intensive care were collected from patients' medical records.
The use of 179 catheters in 116 patients was evaluated. Mean age at CPNB placement was 15.1 years (median, 14.7; range, 0.4-26.9). The most frequent indication for CPNB was surgery (89.4%), most commonly orthopedic (78.8%). Mean CPNB duration was 7.2 days (median, 5.0; range, 1-81 days). Two cases (1.12%) of CPNBs developed signs of infection, both associated with femoral catheters. The infections were mild and necessitated catheter removal at days 10 and 13, respectively.
Nerve block catheter-associated infections are infrequent at our institution despite prolonged CPNB use. Both patients with infection had femoral catheters and prolonged catheter (≥ 10 days) use.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Analgesia - instrumentation</subject><subject>Anti-Bacterial Agents - therapeutic use</subject><subject>Antibiotics</subject><subject>Catheter-Related Infections - drug therapy</subject><subject>Catheter-Related Infections - epidemiology</subject><subject>Catheters</subject><subject>Child</subject><subject>Critical Care - statistics & numerical data</subject><subject>Female</subject><subject>Hematology</subject><subject>Humans</subject><subject>Incidence</subject><subject>Infant</subject><subject>infection</subject><subject>Infections</subject><subject>Intensive care</subject><subject>Length of Stay - statistics & numerical data</subject><subject>Male</subject><subject>Medical Oncology</subject><subject>Nerve Block - instrumentation</subject><subject>oncology</subject><subject>pain</subject><subject>peripheral nerve block</subject><subject>Peripheral Nerves - drug effects</subject><subject>Retrospective Studies</subject><subject>Risk Assessment</subject><subject>Tennessee - epidemiology</subject><subject>Time Factors</subject><subject>Young Adult</subject><issn>1155-5645</issn><issn>1460-9592</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkV9v0zAUxSMEYqPwFZAlXnhJ5j-x47wgoQm2SdMQaAiJF8txb1q3iV1sp7Tffu46KsAvvvL93aNzfYoCEVyRfC5WFakFLlve0opiQivMpMTV7llxfmo8zzXhvOSi5mfFqxhXGBNGBX1ZnFHKZSNJe178_mbjGvkeGZ2WkCCUOkZvrE4wR9b1YJL1Lldo7ye3QEsYdfKDX-wvvDOPBdroZMGliAIYsFubscG7RZnVRrSBYDdLCHpADsIWUDd4s46vixe9HiK8ebpnxffPn-4vr8vbL1c3lx9vS8NJm0oJLZmTjlLJBTOym7OaY1rz3gghJBUdoTUzjOhWtLUBwqXoOtxRIIDzC2ez4sNRdzN1I8xN9pmtqE2wow575bVV_3acXaqF3ypWU1pn8Vnx_kkg-F8TxKRGGw0Mg3bgp6iIaBqW_1K0GX33H7ryU3B5PUWabJc1tRSZkkfKBB9jgP5khmB1SFet1CFEdQhRHdJVj-mqXR59-_cyp8E_cWagPAI2Jtid-jqslcguufpxd6XuyPU9_flVKsIeAIQhsq0</recordid><startdate>20121101</startdate><enddate>20121101</enddate><creator>Anghelescu, Doralina L.</creator><creator>Harris, Brittney L.</creator><creator>Faughnan, Lane G.</creator><creator>Oakes, Linda L.</creator><creator>Windsor, Kelley B.</creator><creator>Wright, Becky B.</creator><creator>McCullers, Jonathan A.</creator><general>Blackwell Publishing Ltd</general><general>Wiley Subscription Services, Inc</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20121101</creationdate><title>Risk of catheter-associated infection in young hematology/oncology patients receiving long-term peripheral nerve blocks</title><author>Anghelescu, Doralina L. ; Harris, Brittney L. ; Faughnan, Lane G. ; Oakes, Linda L. ; Windsor, Kelley B. ; Wright, Becky B. ; McCullers, Jonathan A.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c519t-8e91d1b228563c8bd3450245fc666826b1243c31a9694ce1586bb0b2e1e069453</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Analgesia - instrumentation</topic><topic>Anti-Bacterial Agents - therapeutic use</topic><topic>Antibiotics</topic><topic>Catheter-Related Infections - drug therapy</topic><topic>Catheter-Related Infections - epidemiology</topic><topic>Catheters</topic><topic>Child</topic><topic>Critical Care - statistics & numerical data</topic><topic>Female</topic><topic>Hematology</topic><topic>Humans</topic><topic>Incidence</topic><topic>Infant</topic><topic>infection</topic><topic>Infections</topic><topic>Intensive care</topic><topic>Length of Stay - statistics & numerical data</topic><topic>Male</topic><topic>Medical Oncology</topic><topic>Nerve Block - instrumentation</topic><topic>oncology</topic><topic>pain</topic><topic>peripheral nerve block</topic><topic>Peripheral Nerves - drug effects</topic><topic>Retrospective Studies</topic><topic>Risk Assessment</topic><topic>Tennessee - epidemiology</topic><topic>Time Factors</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Anghelescu, Doralina L.</creatorcontrib><creatorcontrib>Harris, Brittney L.</creatorcontrib><creatorcontrib>Faughnan, Lane G.</creatorcontrib><creatorcontrib>Oakes, Linda L.</creatorcontrib><creatorcontrib>Windsor, Kelley B.</creatorcontrib><creatorcontrib>Wright, Becky B.</creatorcontrib><creatorcontrib>McCullers, Jonathan A.</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Pediatric anesthesia</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Anghelescu, Doralina L.</au><au>Harris, Brittney L.</au><au>Faughnan, Lane G.</au><au>Oakes, Linda L.</au><au>Windsor, Kelley B.</au><au>Wright, Becky B.</au><au>McCullers, Jonathan A.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Risk of catheter-associated infection in young hematology/oncology patients receiving long-term peripheral nerve blocks</atitle><jtitle>Pediatric anesthesia</jtitle><addtitle>Paediatr Anaesth</addtitle><date>2012-11-01</date><risdate>2012</risdate><volume>22</volume><issue>11</issue><spage>1110</spage><epage>1116</epage><pages>1110-1116</pages><issn>1155-5645</issn><eissn>1460-9592</eissn><abstract>Continuous peripheral nerve blocks (CPNBs) are increasingly used to control postoperative and chronic pain. At our pediatric oncology institution, the duration of CPNBs is often prolonged. The risk of catheter-associated infection with prolonged CPNBs has not been previously investigated.
We analyzed the incidence of CPNB-related infection and its relation to catheter duration, catheter site, intensive care stay, and antibiotic coverage.
All CPNBs placed at our institution between August 1, 2005 and October 31, 2010 were studied. Primary diagnosis and the site, indication, duration, and infectious adverse effects of CPNBs were obtained from our Pain Service QI database. Patients' age and sex, antibiotic administration, and number of days in intensive care were collected from patients' medical records.
The use of 179 catheters in 116 patients was evaluated. Mean age at CPNB placement was 15.1 years (median, 14.7; range, 0.4-26.9). The most frequent indication for CPNB was surgery (89.4%), most commonly orthopedic (78.8%). Mean CPNB duration was 7.2 days (median, 5.0; range, 1-81 days). Two cases (1.12%) of CPNBs developed signs of infection, both associated with femoral catheters. The infections were mild and necessitated catheter removal at days 10 and 13, respectively.
Nerve block catheter-associated infections are infrequent at our institution despite prolonged CPNB use. Both patients with infection had femoral catheters and prolonged catheter (≥ 10 days) use.</abstract><cop>Oxford, UK</cop><pub>Blackwell Publishing Ltd</pub><pmid>22587819</pmid><doi>10.1111/j.1460-9592.2012.03880.x</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Pediatric anesthesia, 2012-11, Vol.22 (11), p.1110-1116 |
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| source | MEDLINE; Access via Wiley Online Library |
| subjects | Adolescent Adult Analgesia - instrumentation Anti-Bacterial Agents - therapeutic use Antibiotics Catheter-Related Infections - drug therapy Catheter-Related Infections - epidemiology Catheters Child Critical Care - statistics & numerical data Female Hematology Humans Incidence Infant infection Infections Intensive care Length of Stay - statistics & numerical data Male Medical Oncology Nerve Block - instrumentation oncology pain peripheral nerve block Peripheral Nerves - drug effects Retrospective Studies Risk Assessment Tennessee - epidemiology Time Factors Young Adult |
| title | Risk of catheter-associated infection in young hematology/oncology patients receiving long-term peripheral nerve blocks |
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