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    Central venous access device-related sheaths: a predictor of infective and thrombotic incidence?

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    Authors
    Hill, Steve
    Hamblett, Ian
    Brady, Samantha
    Vasileukaya, Sviatlana
    Zuzuarregui, Ibon
    Martin, Fiona
    Affiliation
    Procedure Team Manager, The Christie Hospital, Manchester
    Issue Date
    2019
    
    Metadata
    Show full item record
    Abstract
    Central vascular access device (CVAD)-related sheaths, sometimes described as 'fibrin sheaths', may result in minor or significant sequelae, from persistent withdrawal occlusion (PWO) to infective sheaths associated with increased morbidity and mortality. The authors studied 179 patients who underwent isotope scans, where isotope was infused via the CVAD. Isotope was found to bind to the sheaths around the catheters of some patients. The amount of uptake was taken to be an extent to which a sheath had developed around the CVAD. The degree of uptake of isotope was categorised into three groups: low uptake, moderate uptake and high uptake. Patients were then followed up from the date the CVAD was inserted to 12 months after the date of the isotope scan, until the device was removed or to the date the patient died, to identify incidence of infection, thrombosis and PWO. PWO incidence in all levels of uptake was around 5-7%. Bloodstream infection (BSI) incidence for low uptake was 7% (9/130), moderate uptake 10% (3/30) and for patients with significant uptake 16% (3/19). Thrombosis for no uptake was less than 1% (1/130), moderate uptake 7% (2/30), and significant uptake had no incidence of thrombosis. Total complications: no uptake 15%, moderate uptake 23% and significant uptake 21%. This single-centre study showed that patients with isotope-highlighted sheaths experienced higher incidence of infective, thrombotic and total complications.
    Citation
    Hill S, Hamblett I, Brady S, Vasileukaya S, Zuzuarregui I, Martin F. Central venous access device-related sheaths: a predictor of infective and thrombotic incidence? British journal of nursing. 2019;28(19):S10-S8.
    Journal
    British Journal of Nursing
    URI
    http://hdl.handle.net/10541/622564
    DOI
    10.12968/bjon.2019.28.19.S10
    PubMed ID
    31647744
    Additional Links
    https://dx.doi.org/10.12968/bjon.2019.28.19.S10
    Type
    Article
    Language
    en
    ae974a485f413a2113503eed53cd6c53
    10.12968/bjon.2019.28.19.S10
    Scopus Count
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