Department of Anaesthesiology and Reanimation, Istanbul Saglik Bilimleri University Basaksehir Cam and Sakura Hospital, Istanbul, Turkey.
Department of Infectious Diseases and Microbiology, Istanbul Saglik Bilimleri University Basaksehir Cam and Sakura Hospital, Istanbul, Turkey.
Medicine (Baltimore). 2024 Oct 4;103(40):e39969. doi: 10.1097/MD.0000000000039969.
In the low-weight newborn patient group, the development of catheter related bloodstream infections after cardiac surgery significantly impacts morbidity and mortality. In our study, the effects of choosing femoral or internal jugular vein localization in newborns on postoperative infection will be examined. Our hypothesis is that there may be a higher risk of catheter related bloodstream infections in the femoral region. This study was conducted retrospectively on newborn cases who underwent congenital heart surgery between September 1, 2020, and March 1, 2022. The cases were divided into 2 groups: those with central catheters inserted in the femoral and in internal jugular veins. Postoperative infection parameters were examined and the results were statistically evaluated. The study was conducted with a total of 201 newborn cases, of which 61.2% (n = 123) were male and 38.8% (n = 78) were female. The age of the cases ranged from 0 to 1 month, with a mean of 12 ± 9 days. Weight measurements ranged from 1.8 to 5.5 kg, with a mean of 3.20 ± 0.66 kg. Central catheters were placed in the femoral vein (FV) region in 71.6% of the babies (n = 144) and in the internal jugular vein region in 28.4% (n = 57). When culture results were examined between postoperative days 3 to 14, blood culture tests were positive in 12.4% (n = 25). The most common bacteria in positive cases were Klebsiella spp. (n = 13) and methicillin-resistant Staphylococcus aureus (n = 5). There was no statistically significant difference in blood culture results between the groups (P > .05). Changes in white blood cells, C-reactive protein, and procalcitonin measurements between preoperative and postoperative day 3 did not show statistically significant difference between the groups (P > .05). According to the results of our study, the placement of FV and internal jugular vein in neonates undergoing cardiac surgery did not differ in terms of postoperative infection risk. With appropriate sterilization, preventive measures and care considerations, FV or internal jugular vein region may be preferred based on the practitioner's expertise and choice in this patient group.
在低体重新生儿患者群体中，心脏手术后导管相关血流感染的发展显著影响发病率和死亡率。在我们的研究中，将检查新生儿选择股静脉或颈内静脉定位对术后感染的影响。我们的假设是股静脉区域可能存在更高的导管相关血流感染风险。本研究回顾性分析了 2020 年 9 月 1 日至 2022 年 3 月 1 日期间接受先天性心脏病手术的新生儿病例。病例分为两组：股静脉和颈内静脉内置入中心导管。检查术后感染参数，并进行统计学评估。本研究共纳入 201 例新生儿病例，其中 61.2%（n=123）为男性，38.8%（n=78）为女性。病例年龄 0 至 1 个月，平均 12±9 天。体重测量范围为 1.8 至 5.5kg，平均 3.20±0.66kg。71.6%的婴儿（n=144）中心导管放置在股静脉（FV）区域，28.4%（n=57）在颈内静脉区域。在术后 3 至 14 天检查培养结果时，12.4%（n=25）血液培养阳性。阳性病例中最常见的细菌是肺炎克雷伯菌（n=13）和耐甲氧西林金黄色葡萄球菌（n=5）。两组间血培养结果无统计学差异（P>.05）。两组间术前至术后第 3 天白细胞、C 反应蛋白和降钙素原测量值的变化无统计学差异（P>.05）。根据我们的研究结果，心脏手术新生儿股静脉和颈内静脉置管在术后感染风险方面没有差异。在适当的消毒、预防措施和护理考虑下，在该患者群体中，可根据从业者的专业知识和选择，优先考虑股静脉或颈内静脉区域。
