Pediatric cancer patients whose central lines are used to treat them at home develop three times as many dangerous bloodstream infections from their devices than their hospitalized counterparts, according to the results of a new Johns Hopkins Children's Center study.
Findings of the research, reported online July 23 in the journal Pediatric Blood & Cancer, provide valuable insight into the safety of central line uses outside the hospital and underscore the need to carefully evaluate the benefits and risk of sending a child home with one, the investigators say.
Furthermore, the results highlight the importance of better understanding the risks of at-home central line care and designing infection-prevention strategies.
"The health care system as a whole has spent a lot of time and energy studying hospital acquired bloodstream infections and has made serious progress in reducing their burden as a result. It is now time that we did the same for central line infections acquired outside the hospital," says lead investigator Michael Rinke, M.D., Ph.D., a pediatrician and safety expert at Johns Hopkins Children's Center.
"Some children with central lines do well at home and will have no complications, but based on our findings, we feel clinicians should remain vigilant when sending home certain special categories of pediatric cancer patients who face higher infection risk by virtue of their condition, device type or a combination of the two," Rinke adds.
A central line, or a central venous catheter, is a tube placed into a major blood vessel in the neck, chest or groin to serve as a temporary portal for injected medications and fluids. Inserted incorrectly, mishandled or simply handled too frequently, the central line can become a gateway for bacteria into the bloodstream, which can lead to serious complications, including organ damage and even death. Beyond the human toll, each infection can cost up to $45,000 in a
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Johns Hopkins Medicine