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Sepsis outcomes in infants and children with central venous catheters: percutaneous versus surgical insertion
1Michael Reese Hospital and Medical Center, Chicago, IL, USA.
Objective:
To review the literature on central venous catheters (CVCs) in infants and children.
Data Sources:
Published surgical, medical, nursing, and nutritional studies from 1968 to the present.
Study Selection:
More than 250 studies were reviewed; selection criteria for the 64 studies chosen included age, percutaneous CVC (PCVC) or surgical CVC (SCVC) use, and defined rate of sepsis.
Data Extraction:
Included study purpose, sample size and age, indications for total parenteral nutrition, insertion method and sites, number of CVCs, and sepsis outcomes.
Data Synthesis:
Yielded weighted mean sepsis rates that were 3.5 times higher for SCVC use in neonatal and/or pediatric populations; subanalyses of homogeneous groups of studies yielded rates that were 2.5 to 3.8 times higher.
Conclusions:
Percutaneous CVC insertion should be given primary consideration for neonatal and pediatric intensive-care patients.