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  • A GAVeCeLT bundle for central venous catheterization in neonates and children: A prospective clinical study on 729 cases

    A GAVeCeLT bundle for central venous catheterization in neonates and children: A prospective clinical study on 729 cases

    The Italian Group for Long Term Venous Access Devices (GAVeCeLT) has developed an insertion bundle for central venous catheterization in neonates, infants, and children, which includes seven evidence-based strategies: (1) preprocedural ultrasound evaluation, (2) appropriate aseptic technique, (3) ultrasound guided venipuncture, (4) intraprocedural tip location by non-radiological methods, (5) proper choice of the exit site by tunneling, (6) sutureless securement, and (7) protection of the exit site using glue and transparent membranes.
    The results of this prospective study strongly validate the hypothesis that an insertion bundle is highly effective in optimizing the safety of the maneuver, reducing immediate, early, and late complications.

    Authors:
    Mauro Pittiruti1 , Davide Celentano2 , Giovanni Barone3 , Vito D’Andrea4 , Maria Giuseppina Annetta5 and Giorgio Conti2

    1 Department of Surgery, University Hospital “A. Gemelli,” Rome, Italy
    2 Pediatric Intensive Care Unit, University Hospital “A. Gemelli,” Rome, Italy
    3 Neonatal Intensive Care Unit, “Infermi” Hospital, Rimini, Italy
    4 Neonatal Intensive Care Unit, University Hospital “A. Gemelli,” Rome, Italy
    5 Department of Anesthesia and Intensive Care, University Hospital “A. Gemelli,” Rome, Italy

    Corresponding author: Mauro Pittiruti, Department of Surgery, University Hospital “A. Gemelli,” Largo Francesco Vito 1, Rome, Lazio 00168, Italy. Email: mauropittiruti@me.com

    The Journal of Vascular Access 1–12

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  • Neonatal Feeding Tube Colonization and the Potential Effect on Infant Health_ A Review

    Neonatal Feeding Tube Colonization and the Potential Effect on Infant Health_ A Review

    Infants in the neonatal intensive care unit (NICU) often require feeding tubes (FT) for weeks to months. Because FTs are in near constant contact with human milk and/or formula, rapid and extensive bacterial growth is possible. Due to their immature immunologic and gastrointestinal (GI) systems, infants may be at significant health risk due to FT colonization.
    The purpose of this review was to describe and summarize the evidence regarding FT bacterial colonization in infants and identify gaps needing further investigation.
    In 10 studies they found evidence that neonatal FTs may contain high quantities of potentially pathogenic and antibiotic resistant bacteria and longer dwell times may increase the bacterial load.

    Authors:
    Leslie A. Parker1 *, Marina Magalhães1 , Katelyn Desorcy-Scherer1 , Monica Torrez Lamberti2 , Graciela L. Lorca2 and Josef Neu3
    1 Department of Biobehavioral Nursing Science, College of Nursing, University of Florida, Gainesville, FL, United States,
    2 Department of Microbiology and Cell Science, Genetics Institute, Institute of Food and Agricultural Sciences, University of Florida, Gainesville, FL, United States,
    3 Division of Neonatology, Department of Pediatrics, College of Medicine, University of Florida, Gainesville, FL, United States

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  • Practical session of Ultra Sound during the NEVAT meeting

    Practical session of Ultra Sound during the NEVAT meeting

    During the NEVAT meeting, there was a practical session on how to perform ultrasound given by one of our active members:

    Dr. Robin Van der Lee
    Neonatologist
    Amalia Children’s Hospital, Radboudumc – Nijmegen, The Netherlands

    https://videopress.com/v/t7ckyRv9?resizeToParent=true&cover=true&preloadContent=metadata&useAverageColor=true
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  • Using a Plastic Drape to Reduce Hypothermia in Premature Neonates During Peripherally Inserted Central Catheter Placement

    Using a Plastic Drape to Reduce Hypothermia in Premature Neonates During Peripherally Inserted Central Catheter Placement

    Premature neonates require assisted heating devices for thermoregulation in the neonatal intensive care unit (NICU) during peripherally inserted central catheter (PICC).
    This quality improvement project’s goal was to reduce the hypothermia rate in very low birth-weight (VLBW) neonates by replacing cloth blanket/towels with a plastic drape during PICC placement.
    The FOCUS-PDSA method was used to implement the intervention (plastic drape) over 3 months, during 58 PICC procedures in a level 3 NICU.
    Post-PICC hypothermia rates were significantly lower for the intervention group than for the concurrent cloth cohort (P = .004).
    A plastic drape shows promise in improving nursing practice by providing improved thermoregulation for premature neonates during PICC placement.

    Authors: Huong (Kelle) T. Phan, DNP, RN, NNP-BC; Teresa M. McIntyre, PhD, MA, MEd, FEHPS

    Correspondence: Huong (Kelle) T. Phan, DNP, RN, NNP-BC, University of Houston, 14000 University Blvd, Sugar Land, TX 77479 (khphan@uh.edu).

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  • Cyanoacrylate Securement in Neonatal PICC Use

    Cyanoacrylate Securement in Neonatal PICC Use

    A 4-Year Observational Study

    This was a retrospective observational analysis of routinely collected anonymized intravenous therapy-related data.

    The results showed that the use of an approved medical grade adhesive for catheter securement resulted in significantly less therapy failures, compared with the control group. This remains significant after adjusting for day of insertion, gestational age, birth weight, and catheter type.

    Authors: Matheus van Rens, RN, MaANP, NNP; Nuha Abdelghafar M. A. Nimeri, MD, CABP; Timothy R. Spencer, RN, APRN, BHSc, DipAppSc, IntCare Cert, VA-BC; Kevin Hugill, PhD, RN, BSc, GCE, MSc; Airene L. V. Francia, RN, BSc; Tawa Olayemi Olukade, MBBS, MSc, MPH; Mohamad Adnan Mahmah, MD, CABP

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  • Strategies to prevent central line-associated bloodstream infections in acute-care hospitals: 2022 Update

    Strategies to prevent central line-associated bloodstream infections in acute-care hospitals: 2022 Update

    The intent of this document is to highlight practical recommendations in a concise format designed to assist acute-care hospitals in implementing and prioritizing their central line-associated bloodstream infection (CLABSI) prevention efforts. This document updates the Strategies to Prevent Central Line-Associated Bloodstream Infections in Acute-Care Hospitals published in 2014. This expert guidance document is sponsored by the Society for Healthcare Epidemiology of America (SHEA). It is the product of a collaborative effort led by SHEA, the Infectious Diseases Society of America (IDSA), the Association for Professionals in Infection Control and Epidemiology (APIC), the American Hospital Association (AHA), and The Joint Commission, with major contributions from representatives of a number of organizations and societies with content expertise.

    Authors: Niccolò Buetti MD, MSc, PhD, Jonas Marschall MD, MSc , Marci Drees MD, MS , Mohamad G. Fakih MD, MPH , Lynn Hadaway MEd, RN, NPD-BC, CRNI , Lisa L. Maragakis MD, MPH , Elizabeth Monsees PhD, MBA, RN, CIC , Shannon Novosad MD MPH, Naomi P. O’Grady MD, Mark E. Rupp MD , Joshua Wolf MBBS, PhD, FRACP, Deborah Yokoe MD, MPH and Leonard A. Mermel DO, ScM

    Buetti N, et al. (2022). Strategies to prevent central line-associated bloodstream infections in acute-care hospitals: 2022 Update. Infection Control & Hospital Epidemiology,
    Author for correspondence: Dr. Leonard A. Mermel, E-mail: lmermel@lifespan.org

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  • Peripherally inserted central catheters versus non-tunnelled ultrasound-guided central venous catheters in newborns: a retrospective observational study

    Peripherally inserted central catheters versus non-tunnelled ultrasound-guided central venous catheters in newborns: a retrospective observational study

    This is an observational study including a large sample of 1333 neonates. The study provides information on the insertion success rates and complications of peripherally inserted central catheters and non-tunnelled ultrasoundguided central venous catheters in neonates.
    The aim was to compare the success rates and other catheter-related parameters between peripherally inserted central catheters (PICCs) and non-tunnelled ultrasound-guided central venous catheters (USG-CVCs) including femoral, jugular, brachiocephalic and subclavian lines.

    Authors:
    Mohammad A A Bayoumi ,1 Roland van Rens ,1 Prem Chandra,2 Deena Shaltout,3 Ashraf Gad,1 Einas E Elmalik ,1 Samer Hammoudeh2
    1 Neonatal Intensive Care Unit (NICU), Women’s Wellness and Research Center (WWRC), Hamad Medical Corporation, Doha, Qatar
    2 Medical Research Center, Hamad Medical Corporation, Doha, Qatar 3 Medical Education Department, Hamad Medical Corporation, Doha, Qatar

    44.-PICC-vs-non-tunneled-US-guided-venous-catheters-in-newbornsDownload

    Bayoumi MAA, van Rens R, Chandra P, et al. Peripherally inserted central catheters versus non tunnelled ultrasound-guided central venous catheters in newborns: a retrospective observational study. BMJ Open 2022;12:e058866. doi:10.1136/ bmjopen-2021-058866

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  • Use of intracavitary-ECG for tip location of femorally inserted central catheters

    Use of intracavitary-ECG for tip location of femorally inserted central catheters

    Femorally inserted central catheters (FICCs) are frequently required for central access in children. Ultrasound can accurately locate the catheter tip in most cases and its use is increasing in clinical vascular access practice. In patients with poor acoustic windows, intracavitary electrocardiogram (IC-ECG) is an alternative to ultrasound-guidance for FICC positioning.
    The use of FICCs in children has increased in recent years. Ultrasound has emerged as a reliable method of assessing FICC tip location. IC-ECG is an accurate and complementary method of assessing FICC tip location, but can be a primary method when ultrasound is not available or cannot directly visualize the catheter. IC-ECG P-wave characteristics identify optimal tip position at the inferior cavoatrial junction and are different from characteristics at the superior cavoatrial junction.

    Authors:
    Mark D Weber, Adam S Himebauch and Thomas Conlon

    Department of Anesthesiology and Critical Care Medicine, Children’s Hospital of Philadelphia, Philadelphia, PA, USACorresponding author:Mark D Weber, Critical Care Nurse Practitioner, Department of Anesthesiology and Critical Care Medicine, Children’s Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA 19104, USA.
    Email: weberm@email.chop.edu

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    The Journal of Vascular Access 1 –5 December 2020

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  • Comparison between sedation room and operating room in central venous catheter positioning in children

    Comparison between sedation room and operating room in central venous catheter positioning in children

    Placement of central venous access devices is a clinical procedure associated with some risk of adverse events and with a relevant cost. Careful choice of the device, appropriate insertion technique, and proper management of the device are well-known strategies commonly adopted to achieve an optimal clinical result. However, the environment where the procedure takes place may have an impact on the overall outcome in terms of safety and cost-effectiveness.In this study, they divided the patients in two groups: in group A the central venous access device was inserted in the operating room, while in group B the central venous access device was inserted in the sedation room of the Pediatric Intensive Care Unit.

    They found that the insertion of the device in a sedation room rather than in the operating room was associated with a relevant reduction in costs, with no difference in terms of immediate, early, or late complications. The benefits include an easier periprocedural management of the patient, less radiation exposure, and more comfortable and welcoming environment for the child and his parents.

    Authors:
    Antonio Chiaretti1 , Mauro Pittiruti2 , Giovanni Sassudelli1 ,Giorgio Conti3 , Marco Rossi4 , Silvia Maria Pulitan`o3 ,Aldo Mancino3 , Angela Pusateri4 , Antonio Gatto1 and Federica Tosi4

    1 Department of Pediatrics, Fondazione Policlinico Universitario AgostinoGemelli, IRCCS, Rome, Italy
    2 Department of Surgery, Fondazione Policlinico Universitario AgostinoGemelli, IRCCS, Rome, Italy
    3 Pediatric Intensive Care Unit, Fondazione Policlinico UniversitarioAgostino Gemelli, IRCCS, Rome, Italy
    4 Department of Anesthesia and Pain Therapy, Fondazione PoliclinicoUniversitario Agostino Gemelli, IRCCS, Rome, Italy

    Corresponding author: Antonio Gatto, Institute of Pediatrics, Fondazione PoliclinicoUniversitario Agostino, Gemelli IRCCS, Largo Agostino Gemelli 8,00168 Rome, Italy.
    Email: antonio.gatto@policlinicogemelli.it

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    The Journal of Vascular Access2021, Vol. 22(2) 184–188

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  • Ultrasound-guided supraclavicular cannulation of the brachiocephalic vein may reduce central line–associated bloodstream infection in preterm infants

    Ultrasound-guided supraclavicular cannulation of the brachiocephalic vein may reduce central line–associated bloodstream infection in preterm infants

    Is US-guided guided supraclavicular cannulation of the BCV in very-low-birth-weight preterm infants associated with a reduced incidence of CLABSI compared to standard ECCs?
    The objective of this study was to assess the risk of central line–associated bloodstream infection (CLABSI) of ultrasound (US)-guided cannulation of the brachiocephalic vein (BCV) compared to standard epicutaneous cava catheters (ECCs) in preterm infants.

    Authors:
    Ignacio Oulego-Erroz1,2,3, Alba Fernández-García4, Beatriz Álvarez-Juan4, Sandra Terroba-Seara4; Paula Alonso Quintela3,4; Antonio Rodríguez-Núñez5

    1 Pediatric Intensive Care Unit, Complejo Asistencial Universitario deLeón, León, Spain
    2 Working Group on Bedside Ultrasound of the Spanish Society ofPediatric Intensive Care (SECIP), León, Spain
    3 IBIOMED – Biomedicine Institute of León, University of León,León, Spain
    4 Neonatal Intensive Care Unit, Complejo Asistencial Universitario deLeón, León, Spain
    5 Pediatric Critical, Intermediate and Palliative Care Section, Hospital Clínico Universitario de Santiago, Research Institute of Santiago(IDIS), Santiago, Spain

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    European Journal of Pediatrics (2020) 179:1655–1663

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