School of Medicine, University of Utah, Salt Lake City, UT 84132, USA.
Department of Radiology and Imaging Sciences, School of Medicine, University of Utah, Salt Lake City, UT 84132, USA.
Tomography. 2022 Mar 1;8(2):627-634. doi: 10.3390/tomography8020052.
Placement of image-guided tunneled and non-tunneled large-bore central venous catheters (CVCs) are common procedures in interventional radiology. Although leukopenia and/or thrombocytopenia are common at the time of placement, the roles these factors may have in subsequent catheter-related infection have yet to be investigated. A single-institution retrospective review was performed in patients who underwent CVC placement in interventional radiology between 11/2018-6/2019. The electronic medical record was used to obtain demographics, procedure details, pre-placement laboratory values, and the subsequent 90-day follow-up. A total of 178 tunneled and non-tunneled CVCs met inclusion criteria during this time period. White blood cell (WBC) and platelet counts were found to be significant risk factors for subsequent infection. Administration of pre-procedure antibiotics was not found to be a significant factor for subsequent infection ( = 0.075). Leukopenia and thrombocytopenia at the time of CVC placement are both risk factors of line infection for tunneled large-bore CVCs. This should lead to the consideration of using a non-tunneled CVC when clinically feasible, or the delayed placement of these catheters until counts recover.
在介入放射学中,引导下经皮隧道和非隧道大口径中央静脉导管(CVC)的置管是常见的操作。尽管在置管时通常会出现白细胞减少症和/或血小板减少症,但这些因素在随后的导管相关性感染中的作用尚未得到研究。对 2018 年 11 月至 2019 年 6 月期间在介入放射科接受 CVC 置管的患者进行了单机构回顾性研究。电子病历用于获取人口统计学、手术细节、置管前实验室值和随后的 90 天随访。在此期间,共有 178 例经皮隧道和非隧道 CVC 符合纳入标准。发现白细胞(WBC)和血小板计数是随后感染的显著危险因素。术前给予抗生素治疗与随后的感染无关(= 0.075)。CVC 置管时的白细胞减少症和血小板减少症均是隧道大口径 CVC 感染的危险因素。这应导致考虑在临床可行时使用非隧道 CVC,或者在计数恢复后延迟放置这些导管。