Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/12237
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dc.contributor.authorChua, Horng-Ruey-
dc.contributor.authorSchneider, Antoine G-
dc.contributor.authorSherry, Norelle L-
dc.contributor.authorLotfy, Nadiah-
dc.contributor.authorChan, Matthew J-
dc.contributor.authorGaltieri, Jonathan-
dc.contributor.authorWong, Geoffrey R-
dc.contributor.authorLipcsey, Miklos-
dc.contributor.authorMatte, Cauê de Araujo-
dc.contributor.authorCollins, Allison L-
dc.contributor.authorGarcia-Alvarez, Mercedes-
dc.contributor.authorBellomo, Rinaldo-
dc.date.accessioned2015-05-16T01:53:43Z-
dc.date.available2015-05-16T01:53:43Z-
dc.date.issued2014-06-02-
dc.identifier.citationAmerican Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation 2014; 64(6): 909-17en_US
dc.identifier.otherPUBMEDen
dc.identifier.urihttps://ahro.austin.org.au/austinjspui/handle/1/12237en
dc.description.abstractThe risk of catheter-related infection or bacteremia, with initial and extended use of femoral versus nonfemoral sites for double-lumen vascular catheters (DLVCs) during continuous renal replacement therapy (CRRT), is unclear.Retrospective observational cohort study.Critically ill patients on CRRT in a combined intensive care unit of a tertiary institution.Femoral versus nonfemoral venous DLVC placement.Catheter-related colonization (CRCOL) and bloodstream infection (CRBSI).CRCOL/CRBSI rates expressed per 1,000 catheter-days.We studied 458 patients (median age, 65 years; 60% males) and 647 DLVCs. Of 405 single-site only DLVC users, 82% versus 18% received exclusively 419 femoral versus 82 jugular or subclavian DLVCs, respectively. The corresponding DLVC indwelling duration was 6±4 versus 7±5 days (P=0.03). Corresponding CRCOL and CRBSI rates (per 1,000 catheter-days) were 9.7 versus 8.8 events (P=0.8) and 1.2 versus 3.5 events (P=0.3), respectively. Overall, 96 patients with extended CRRT received femoral-site insertion first with subsequent site change, including 53 femoral guidewire exchanges, 53 new femoral venipunctures, and 47 new jugular/subclavian sites. CRCOL and CRBSI rates were similar for all such approaches (P=0.7 and P=0.9, respectively). On multivariate analysis, CRCOL risk was higher in patients older than 65 years and weighing >90kg (ORs of 2.1 and 2.2, respectively; P<0.05). This association between higher weight and greater CRCOL risk was significant for femoral DLVCs, but not for nonfemoral sites. Other covariates, including initial or specific DLVC site, guidewire exchange versus new venipuncture, and primary versus secondary DLVC placement, did not significantly affect CRCOL rates.Nonrandomized retrospective design and single-center evaluation.CRCOL and CRBSI rates in patients on CRRT are low and not influenced significantly by initial or serial femoral catheterizations with guidewire exchange or new venipuncture. CRCOL risk is higher in older and heavier patients, the latter especially so with femoral sites.en_US
dc.language.isoenen
dc.subject.otherAcute kidney injury (AKI)en
dc.subject.otheracute renal failure (ARF)en
dc.subject.othercatheter-related bloodstream infection (CRBSI)en
dc.subject.othercatheter-related colonizationen
dc.subject.othercatheter-related infectionen
dc.subject.othercontinuous renal replacement therapy (CRRT)en
dc.subject.othercritical careen
dc.subject.othercritical illnessen
dc.subject.otherdouble lumen vascular catheteren
dc.subject.otherfemoral venous catheteren
dc.subject.otherguidewire exchange versus new venipunctureen
dc.subject.otherintensive careen
dc.subject.otherjugular and subclavian venous catheteren
dc.subject.otherline infectionen
dc.subject.otherline sepsisen
dc.subject.othernontunneled dialysis catheteren
dc.subject.otherAgeden
dc.subject.otherCatheter-Related Infections.diagnosis.epidemiologyen
dc.subject.otherCentral Venous Catheters.adverse effects.microbiologyen
dc.subject.otherCohort Studiesen
dc.subject.otherFemaleen
dc.subject.otherFemoral Vein.microbiologyen
dc.subject.otherHumansen
dc.subject.otherMaleen
dc.subject.otherMiddle Ageden
dc.subject.otherRenal Replacement Therapy.adverse effects.instrumentationen
dc.subject.otherRetrospective Studiesen
dc.subject.otherTime Factorsen
dc.titleInitial and extended use of femoral versus nonfemoral double-lumen vascular catheters and catheter-related infection during continuous renal replacement therapy.en_US
dc.typeJournal Articleen_US
dc.identifier.journaltitleAmerican Journal of Kidney Diseases : the Official Journal of the National Kidney Foundationen_US
dc.identifier.affiliationIntensive Careen_US
dc.identifier.affiliationDepartment of Surgery, Section of Anaesthesiology and Intensive Care, Uppsala University, Uppsala, Sweden.en_US
dc.identifier.affiliationDepartment of Intensive Care, Centre Hospitalo-Universitaire Vaudois, LaUSAnne, Switzerland.en_US
dc.identifier.affiliationDivision of Nephrology, Department of Medicine, National University Hospital, National University Health System, Singapore.en_US
dc.identifier.affiliationMicrobiologyen_US
dc.identifier.affiliationAustralian and New Zealand Intensive Care Society (ANZICS) Research Centre, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australiaen_US
dc.identifier.affiliationInfectious Diseasesen_US
dc.identifier.doi10.1053/j.ajkd.2014.04.022en_US
dc.description.pages909-17en
dc.relation.urlhttps://pubmed.ncbi.nlm.nih.gov/24882583en
dc.type.contentTexten_US
dc.type.austinJournal Articleen
local.name.researcherBellomo, Rinaldo
item.openairecristypehttp://purl.org/coar/resource_type/c_18cf-
item.cerifentitytypePublications-
item.fulltextNo Fulltext-
item.grantfulltextnone-
item.languageiso639-1en-
item.openairetypeJournal Article-
crisitem.author.deptInfectious Diseases-
crisitem.author.deptInstitute for Breathing and Sleep-
crisitem.author.deptIntensive Care-
crisitem.author.deptData Analytics Research and Evaluation (DARE) Centre-
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