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Remove children's catheters as soon as possible to prevent bloodstream infections
Date:3/31/2011

against the risk of removing it by asking a simple question 'Does this child need a central line for another day?'" says senior author Aaron Milstone, M.D., M.H.S., an infectious disease specialist at Hopkins Children's.

No matter the length of PICC use, the researchers say, the first line of defense against bloodstream infections should always be simple precautions that include rigorous hand-washing before handling the line, regularly changing the dressing that covers the PICC line, and periodically changing the tubes and caps attached to it.

"Even when clinicians follow meticulously basic rules of catheter insertion and maintenance, the risk of infection is never zero," Milstone said. "Reducing the time a child has a PICC is one extra step to minimize that risk."

When researchers compared patients in intensive care with those on regular units, they found an 80 percent higher risk of bloodstream infections among children in intensive care. However, the study showed that more than 30 percent of all infections occurred in children outside of the intensive-care unit, a finding that underscores the need for vigilant monitoring of all children with PICC lines. About one-fifth (22 percent) of infections occurred after patients left the hospital, the researchers found, a finding that points to the importance of educating both parents and home-based caregivers on ways to prevent infections at home.

"Children in intensive care have more severe disease and often require catheters, but it is critical that we remain vigilant about patients with perceived 'lower risk' outside of intensive care, and indeed those outside of the hospital, because they are not immune to infections," says lead investigator Sonali Advani, M.B.B.S., M.P.H.

While hospitals have recently made great strides in reducing the number of central line infections, thousands of people continue to die from them each year, the researchers say.


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Contact: Ekaterina Pesheva
epeshev1@jhmi.edu
410-516-4996
Johns Hopkins Medical Institutions
Source:Eurekalert

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