| dc.rights.license | Atribución-NoComercial 4.0 Internacional |
| dc.contributor.advisor | Espinosa Almanza, Carmelo José |
| dc.contributor.advisor | Ruiz Ávila, Héctor Andrés |
| dc.contributor.author | Mora Urrego, John Edisson |
| dc.date.accessioned | 2021-08-20T16:35:17Z |
| dc.date.available | 2021-08-20T16:35:17Z |
| dc.date.issued | 2021-08 |
| dc.identifier.uri | https://repositorio.unal.edu.co/handle/unal/79983 |
| dc.description | ilustraciones, gráficas, tablas |
| dc.description.abstract | Introducción: La colocación de catéteres venosos centrales (CVC) por guía de
ultrasonido ha venido creciendo en la última década, demostrando reducir de forma
importante las complicaciones mecánicas. Sin embargo, no está claro aún si existe mayor riesgo de complicaciones infecciosas del procedimiento.
Objetivo: Establecer si existe asociación entre el uso de la guía ultrasonográfica (US) en
la colocación del CVC y el desarrollo de bacteriemia asociada a catéter en pacientes
críticamente enfermos de Unidad de Cuidado Intensivo (UCI).
Metodología: Estudio de casos y controles pareado de pacientes adultos críticamente
enfermos en UCI, con indicación de CVC de inserción central entre los años de 2019 a
2021.
Resultados: Se incluyeron 250 pacientes, 76% presentaron infección COVID-19. Se
utilizo guía ultrasonográfica para la inserción del CVC en 72.8% y el sitio anatómico más
frecuente fue vena subclavia en 56%. Los agentes más frecuentes de bacteriemia fueron
Gram negativos en 70%. Se documento una tendencia de asociación entre el uso de guía
US para la inserción de CVC y el desarrollo de bacteriemia (OR 2.16 (IC 95% 0.89-5.21,
p=0.085). Se halló una asociación estadísticamente significativa entre los días de uso del CVC y el desarrollo de bacteriemia OR 1.06 (IC 1.00 - 1.13, p=0.038).
Conclusiones: El uso de guía ultrasonográfica en la colocación de catéteres venosos
centrales muestra una tendencia de asociación con el desarrollo de bacteriemia, siendo el número de días de uso del dispositivo un factor de riesgo independiente, con una menor frecuencia de complicaciones mecánicas. (Texto tomado de la fuente) |
| dc.description.abstract | Introduction: Ultrasonography guided central line insertion has increased in last years, it has proved a significantly reduction in mechanical complications. However, it is no clear if use of ultrasonography associates with more infectious complications.
Objective: To establish whether ultrasonography guided central line insertion is associated with catheter related bloodstream infection increase in critically ill patients in Intensive care Unit.
Methodology: Matched case and control study of critically ill patients in intensive care unit with central line insertion indication between years 2019 to 2021.
Results: We included 250 patients, 76% had COVID-19. Ultrasonography guide was used for central line insertion in 72.8% and subclavian vein was the principal anatomical site used in 56%. Gram negative bacteria was the most frequent etiology in 70%. We
documented a trend of association between ultrasonography guide for central line insertion and catheter related bloodstream infection OR=2.16 (CI 95%, 0.89-5.21, p=0.085). Duration of catheterization was associated with catheter related bloodstream infection OR=1.06 (CI95%, 1.00 - 1.13, p=0.038).
Conclusions: Use of ultrasonography for central line insertion has a trend of association
with catheter related bloodstream infection, with duration of catheterization as an
independent risk factor, and a reduction in mechanical complications. (Text taken from source) |
| dc.format.extent | 59 páginas |
| dc.format.mimetype | application/pdf |
| dc.language.iso | spa |
| dc.publisher | Universidad Nacional de Colombia |
| dc.rights | Derechos reservados al autor, 2021 |
| dc.rights.uri | http://creativecommons.org/licenses/by-nc-nd/4.0/ |
| dc.subject.ddc | 610 - Medicina y salud::614 - Medicina Forense; incidencia de lesiones, heridas, enfermedades; medicina preventiva pública |
| dc.title | Asociación entre el uso de guía ultrasonográfica para la colocación del acceso venoso central con el desarrollo de bacteriemia asociada a catéter en pacientes de la Unidad de Cuidados Intensivos del Hospital Universitario Nacional de Colombia, años 2019 a 2021 |
| dc.type | Trabajo de grado - Especialidad Médica |
| dcterms.audience | Especializada |
| dc.type.driver | info:eu-repo/semantics/masterThesis |
| dc.type.version | info:eu-repo/semantics/acceptedVersion |
| dc.publisher.program | Bogotá - Medicina - Especialidad en Medicina Interna |
| dc.description.degreelevel | Especialidades Médicas |
| dc.description.degreename | Especialista en Medicina Interna |
| dc.description.methods | Estudio de casos y controles pareado de pacientes adultos críticamente enfermos en UCI, con indicación de CVC de inserción central entre los años de 2019 a
2021. |
| dc.description.researcharea | Medicina Intensiva y cuidado crítico |
| dc.identifier.instname | Universidad Nacional de Colombia |
| dc.identifier.reponame | Repositorio Institucional Universidad Nacional de Colombia |
| dc.identifier.repourl | https://repositorio.unal.edu.co/ |
| dc.publisher.department | Departamento de Medicina Interna |
| dc.publisher.faculty | Facultad de Medicina |
| dc.publisher.place | Bogotá, Colombia |
| dc.publisher.branch | Universidad Nacional de Colombia - Sede Bogotá |
| dc.relation.references | 1. Kornbau C, Lee KC, Hughes GD, Firstenberg MS. Central line complications. Int J Crit Illn Inj Sci. 2015 Jul-Sep;5(3):170-8. |
| dc.relation.references | 2. Cardoso R, Rodrigues N, Machado J, Pedrini R. Central Venous Catheterization: An Update Review of Historical Aspects, Indications, Techniques, and Complications. Transl Surg 2017; 2: 66-70. |
| dc.relation.references | 3. Troianos CA, Hartman GS, Glas KE, Skubas NJ, Eberhardt RT, Walker JD, Reeves ST; Councils on Intraoperative Echocardiography and Vascular Ultrasound of the American Society of Echocardiography. Guidelines for performing ultrasound guided vascular cannulation: recommendations of the American Society of Echocardiography and the Society of Cardiovascular Anesthesiologists. J Am Soc Echocardiogr. 2011 Dec;24(12):1291-318. |
| dc.relation.references | 4. Lutwick L, Al-Maani AS, Mehtar S, Memish Z, Rosenthal VD, Dramowski A, Lui G, Osman T, Bulabula A, Bearman G. Managing and preventing vascular catheter infections: A position paper of the international society for infectious diseases. Int J Infect Dis. 2019 Jul;84:22-29. |
| dc.relation.references | 5. Chaves F, Garnacho-Montero J, Del Pozo JL, Bouza E, Capdevila JA, de Cueto M, Domínguez MÁ, Esteban J, Fernández-Hidalgo N, Fernández Sampedro M, Fortún J, Guembe M, Lorente L, Paño JR, Ramírez P, Salavert M, Sánchez M, Vallés J. Executive summary: Diagnosis and Treatment of Catheter-Related Bloodstream Infection: Clinical Guidelines of the Spanish Society of Clinical Microbiology and Infectious Diseases (SEIMC) and the Spanish Society of Intensive Care Medicine and Coronary Units (SEMICYUC). Enferm Infecc Microbiol Clin (Engl Ed). 2018 Feb;36(2):112-119. |
| dc.relation.references | 6. Timsit JF, Baleine J, Bernard L, Calvino-Gunther S, Darmon M, Dellamonica J, Desruennes E, Leone M, Lepape A, Leroy O, Lucet JC, Merchaoui Z, Mimoz O, Misset B, Parienti JJ, Quenot JP, Roch A, Schmidt M, Slama M, Souweine B, Zahar JR, Zingg W, Bodet-Contentin L, Maxime V. Expert consensus-based clinical practice guidelines management of intravascular catheters in the intensive care unit. Ann Intensive Care. 2020 Sep 7;10(1):118. |
| dc.relation.references | 7. Rijnders BJ, Peetermans WE, Verwaest C, Wilmer A, Van Wijngaerden E. Watchful waiting versus immediate catheter removal in ICU patients with suspected catheterrelated infection: a randomized trial. Intensive Care Med. 2004 Jun;30(6):1073-80. |
| dc.relation.references | 8. McGee DC, Gould MK. Preventing complications of central venous catheterization. N Engl J Med. 2003 Mar 20;348(12):1123-33. |
| dc.relation.references | 9. Merrer J, Jonghe BD, Golliot F. et al. Complications of Femoral and Subclavian Venous Catheterization in Critically Ill Patients A Randomized Controlled Trial. JAMA. 2001 Aug 8;286(6):700-7 |
| dc.relation.references | 10. Arvaniti K, Lathyris D, Blot S, Apostolidou-Kiouti F, Koulenti D, Haidich AB. Cumulative Evidence of Randomized Controlled and Observational Studies on Catheter-Related Infection Risk of Central Venous Catheter Insertion Site in ICU Patients: A Pairwise and Network Meta-Analysis. Crit Care Med. 2017 Apr;45(4):e437e448. |
| dc.relation.references | 11. Parienti JJ. Catheter-Related Bloodstream Infection in Jugular Versus Subclavian Central Catheterization. Crit Care Med. 2017 Jul;45(7):e734-e735. |
| dc.relation.references | 12. Parienti JJ, Mongardon N, Mégarbane B, Mira JP, Kalfon P, Gros A, Marqué S, Thuong M, Pottier V, Ramakers M, Savary B, Seguin A, Valette X, Terzi N, Sauneuf B, Cattoir V, Mermel LA, du Cheyron D; 3SITES Study Group. Intravascular Complications of Central Venous Catheterization by Insertion Site. |
| dc.relation.references | 13. Marik PE, Flemmer M, Harrison W. The risk of catheter-related bloodstream infection with femoral venous catheters as compared to subclavian and internal jugular venous catheters: a systematic review of the literature and meta-analysis. Crit Care Med. 2012;40(8):2479–85 |
| dc.relation.references | 14. Ge X, Cavallazzi R, Li C, Pan SM, Wang YW, Wang FL. Central venous access sites for the prevention of venous thrombosis, stenosis and infection. Cochrane Database Syst Rev. 2012 Mar 14;2012(3):CD004084. |
| dc.relation.references | 15. Timsit JF, Bouadma L, Mimoz O, Parienti JJ, Garrouste-Orgeas M, Alfandari S, Plantefeve G, Bronchard R, Troche G, Gauzit R, Antona M, Canet E, Bohe J, Herrault MC, Schwebel C, Ruckly S, Souweine B, Lucet JC. Jugular versus femoral short-termcatheterization and risk of infection in intensive care unit patients. Causal analysis otwo randomized trials. Am J Respir Crit Care Med. 2013 Nov 15;188(10):1232-9. |
| dc.relation.references | 16. Xiong Z, Chen H. Interventions to reduce unnecessary central venous catheter useto prevent central-line-associated bloodstream infections in adults: A systematicreview. Infect Control Hosp Epidemiol. 2018 Dec;39(12):1442-1448. |
| dc.relation.references | 17. Lai NM, Chaiyakunapruk N, Lai NA, ORiordan E, Pau WS, Saint S. Catheterimpregnation, coating or bonding for reducing central venous catheter-relatedinfections in adults. Cochrane Database Syst Rev. 2016 Mar 16;3(3):CD007878. |
| dc.relation.references | 18. Karakitsos D, Labropoulos N, De Groot E, Patrianakos AP, Kouraklis G, Poularas J, Samonis G, Tsoutsos DA, Konstadoulakis MM, Karabinis A. Real-time ultrasoundguided catheterisation of the internal jugular vein: a prospective comparison with thelandmark technique in critical care patients. Crit Care. 2006;10(6):R162. |
| dc.relation.references | 19. Gok F. et al. The effect of ultrasound guidance on central venous catheterassociated bloodstream infection in critical care patients. Acta Medica Mediterranea2013;29: 677 |
| dc.relation.references | 20. Imataki O, Shimatani M, Ohue Y, Uemura M. Effect of ultrasound-guided centralvenous catheter insertion on the incidence of catheter-related bloodstream infectionsand mechanical complications. BMC Infectious Diseases 2019; 19: 857. |
| dc.relation.references | 21. Kunhahamed MO, Abraham SV, Palatty BU, Krishnan SV, Rajeev PC, Gopinathan V. A Comparison of Internal Jugular Vein Cannulation by Ultrasound-Guided andAnatomical Landmark Technique in Resource-Limited Emergency Department SettingJ Med Ultrasound. 2019 May 13;27(4):187-191. |
| dc.relation.references | 22. Buetti N, Mimoz O, Mermel L, Ruckly S, Mongardon N, Dupuis C, Mira JP, Lucet JC, Mégarbane B, Bailly S, Parienti JJ, Timsit JF. Ultrasound guidance and risk focentral venous catheter-related infections in the ICU. A post hoc analysis of individualdata of three multi-centric randomized trials. Clin Infect Dis. 2020 Dec 5:ciaa1817. |
| dc.relation.references | 23. Millington SJ, Lalu MM, Boivin M, Koenig S. Better With Ultrasound: SubclavianCentral Venous Catheter Insertion. Chest. 2019 May;155(5):1041-1048. |
| dc.relation.references | 24. Smallwood N, Dachsel M. Point-of-care ultrasound (POCUS): unnecessarygadgetry or evidence-based medicine? Clin Med (Lond). 2018 Jun;18(3):219-224. |
| dc.relation.references | 25. Aakjær Andersen C, Brodersen J, Davidsen AS, Graumann O, Jensen MBB. Useand impact of point-of-care ultrasonography in general practice: a prospectiveobservational study. BMJ Open. 2020 Sep 17;10(9):e037664. |
| dc.relation.references | 26. Choi WJ, Ha YR, Oh JH, Cho YS, Lee WW, Sohn YD, Cho GC, Koh CY, Do HH,Jeong WJ, Ryoo SM, Kwon JH, Kim HM, Kim SJ, Park CY, Lee JH, Lee JH, Lee DH,Park SY, Kang BS. Clinical Guidance for Point-of-Care Ultrasound in the Emergencyand Critical Care Areas after Implementing Insurance Coverage in Korea. J KoreanMed Sci. 2020 Feb 24;35(7):e54. |
| dc.relation.references | 27. Rothman KJ, Greenland S, Lash TL. Modern Epidemiology. 3rd ed. Philadelphia,PA: Lippincott Williams & Wilkins; 2012. |
| dc.relation.references | 28. Whitley E, Ball J. Statistics review 3: hypothesis testing and P values. Crit Care.2002;6(3):222-5. Erratum in: Crit Care. 2003;7(1):15. |
| dc.relation.references | 29. Ali Z, Bhaskar SB. Basic statistical tools in research and data analysis. Indian JAnaesth. 2016;60(9):662-9. Erratum in: Indian J Anaesth. 2016;60(10):790. |
| dc.relation.references | 30. Kleinbaum DG, Klein M. Logistic regression: a self-learning text. 3rd ed. New York:Springer; 2010. |
| dc.relation.references | 31. Kelsey JL, Whittemore AS, Evans AS, Thompson WD. Methods in observationalepidemiology. 2nd ed. New York: Oxford University Press; 1996. |
| dc.relation.references | 32. Viderman D, Khudaibergenova M, Kemaikin V, Zhumadilov A, Poddighe D.Outbreak of catheter related Burkholderia cepacia sepsis acquired from contaminatedultrasonography gel: the importance of strengthening hospital infection controlmeasures in low resourced settings. Infez Med. 2020 Dec 1;28(4):551-557. PMID:33257630. |
| dc.relation.references | 33. Abdelfattah R, Al-Jumaah S, Al-Qahtani A, Al-Thawadi S, Barron I, Al-Mofada S.Outbreak of Burkholderia cepacia bacteraemia in a tertiary care centre due tocontaminated ultrasound probe gel. J Hosp Infect. 2018 Mar;98(3):289-294. |
| dc.relation.references | 34. Søgaard KK, Baettig V, Osthoff M, Marsch S, Leuzinger K, Schweitzer M, Meier J,Bassetti S, Bingisser R, Nickel CH, Khanna N, Tschudin-Sutter S, Weisser M, BattegayM, Hirsch HH, Pargger H, Siegemund M, Egli A. Community-acquired and hospital acquired respiratory tract infection and bloodstream infection in patients hospitalized with COVID-19 pneumonia. J Intensive Care. 2021 Jan 18;9(1):10. |
| dc.relation.references | 35. Zhang H, Zhang Y, Wu J, Li Y, Zhou X, Li X, Chen H, Guo M, Chen S, Sun F, MaoR, Qiu C, Zhu Z, Ai J, Zhang W. Risks and features of secondary infections in severeand critical ill COVID-19 patients. Emerg Microbes Infect. 2020 Dec;9(1):1958-1964. |
| dc.relation.references | 36. McGraw R, Chaplin T, McKaigney C, Rang L, Jaeger M, Redfearn D, Davison C, Ungi T, Holden M, Yeo C, Keri Z, Fichtinger G. Development and Evaluation of a Simulation-based Curriculum for Ultrasound-guided Central Venous Catheterization. CJEM. 2016 Nov;18(6):405-413. |
| dc.relation.references | 37. Spencer TR, Bardin-Spencer AJ. Pre- and post-review of a standardized ultrasound-guided central venous catheterization curriculum evaluating procedural skills acquisition and clinician confidence. J Vasc Access. 2020 Jul;21(4):440-448. |
| dc.relation.references | 38. Cheng S, Xu S, Guo J, He Q, Li A, Huang L, Liu Z, Li S. Risk Factors of Central Venous Catheter-Related Bloodstream Infection for Continuous Renal Replacement Therapy in Kidney Intensive Care Unit Patients. Blood Purif. 2019;48(2):175-182. |
| dc.relation.references | 39. Kaur M, Gupta V, Gombar S, Chander J, Sahoo T. Incidence, risk factors, microbiology of venous catheter associated bloodstream infections--a prospective study from a tertiary care hospital. Indian J Med Microbiol. 2015 Apr-Jun;33(2):248-54. |
| dc.relation.references | 40. Sahli F, Feidjel R, Laalaoui R. Hemodialysis catheter-related infection: rates, risk factors and pathogens. J Infect Public Health. 2017 Jul-Aug;10(4):403-408. |
| dc.relation.references | 41. Bekçibaşi M, Dayan S, Aslan E, Kortak MZ, Hoşoğlu S. Risk factors for central venous catheter-related bloodstream infections. Infez Med. 2019 Sep 1;27(3):258-265. |
| dc.relation.references | 42. Jonas O, et al. Final report Drug-Resistant Infections: A Threat to our Economic Future. World Bank Group. 2018 March; www.worldbank.org |
| dc.relation.references | 43. Moncaleano V. Boletín informativo, resultados de la vigilancia de la resistencia bacteriana Año 2018, componente pediátrico y adulto. Número 11, Bogotá 2019. www.grebo.org |
| dc.relation.references | 44. Burnham JP, Rojek RP, Kollef MH. Catheter removal and outcomes of multidrugresistant central-line-associated bloodstream infection. Medicine (Baltimore). 2018 Oct;97(42):e12782. |
| dc.rights.accessrights | info:eu-repo/semantics/openAccess |
| dc.subject.decs | COVID-19 |
| dc.subject.decs | Ultrasonografía |
| dc.subject.decs | Ultrasonography |
| dc.subject.decs | Infecciones Relacionadas con Catéteres |
| dc.subject.decs | Catheter-Related Infection |
| dc.subject.proposal | Cuidado crítico |
| dc.subject.proposal | Catéter venoso central |
| dc.subject.proposal | Guía ultrasonográfica |
| dc.subject.proposal | Bacteriemia asociada a catéter |
| dc.subject.proposal | Critical care |
| dc.subject.proposal | Central line |
| dc.subject.proposal | Ultrasonography guide |
| dc.subject.proposal | Catheter related bloodstream infection |
| dc.title.translated | Ultrasonography guide for central line insertion association with catheter related bloodstream infection in patients in intensive care unit of Hospital Universitario Nacional de Colombia, years 2019 yo 2021 |
| dc.type.coar | http://purl.org/coar/resource_type/c_bdcc |
| dc.type.coarversion | http://purl.org/coar/version/c_ab4af688f83e57aa |
| dc.type.content | Text |
| dc.type.redcol | http://purl.org/redcol/resource_type/TM |
| oaire.accessrights | http://purl.org/coar/access_right/c_abf2 |
Correo Electrónico
DNINFOA - SIA
Bibliotecas
Convocatorias
Identidad U.N.
This work is licensed under a Creative Commons Reconocimiento-NoComercial 4.0.This document has been deposited by the author (s) under the following certificate of deposit