ABSTRACT
Introducción: Los catéteres centrales de inserción periférica se han convertido en una prioridad en los neonatos que necesitan terapia intravenosa de larga duración, pero su uso no está exento de riesgos. Objetivo: Describir la aparición de eventos adversos en neonatos portadores de catéteres venosos centrales de inserción periférica y determinar factores de riesgo asociados a ellos. Métodos: Se llevó a cabo un estudio descriptivo transversal en el que se incluyeron la totalidad de neonatos portadores de catéteres venosos centrales de inserción periférica desde el 1 de octubre de 2014 hasta el 30 de septiembre de 2015. Se registraron los eventos adversos y variables sociodemográficas y clínicas relacionadas con los neonatos y los catéteres analizados. Resultados: Se incluyeron en el estudio un total de 116 neonatos y 140 catéteres. Se registraron eventos adversos en el 16,4% de ellos: bacteriemia asociada al catéter (5,7%), obstrucción (5,7%), extravasación (2,1%) y flebitis (2,1%). Los factores asociados a bacteriemia con el odds de prevalencia corresponde a neonatos: < 27 semanas de gestación (OR = 1,2; p = 0,02), con peso < 1.000 g (OR = 6,7; p = 0,02), portadores de catéter > 1 semana (OR = 9,8; p = 0,02) y con perfusión de antibióticos por catéter (OR = 1,3; p < 0,01). La flebitis se asocia con la inserción del catéter en miembros inferiores y cabeza (OR = 1,1; p = 0,03). Los factores asociados a bacteriemia con odds de prevalencia ajustada corresponde a neonatos de peso extremo (OR = 6,38; p = 0,03) y portadores del catéter > 7 días (OR = 9,41; p = 0,04). Conclusiones: La evaluación periódica de eventos adversos relacionados con catéteres es de gran utilidad para elaborar planes de mejora. Esto permitirá extremar la seguridad en los RN más vulnerables, en especial los neonatos con extremo bajo peso que precisan tratamientos muy prolongados
Background: Peripherally inserted central catheters have become a priority in infants who require long-term intravenous therapy, but their use involves certain risks. Objective: The aim of the study was to describe the occurrence of adverse events in newborns with peripherally inserted central catheters and to determine the risk factors associated with them. Methods: A descriptive cross-sectional study was designed and performed. All neonates with peripherally inserted central catheters from October 1st, 2014 to September 30 th, 2015 were included. The adverse events and sociodemographic and clinical variables related to neonates and analyzed catheters were recorded. Results: A total of 140 catheters were placed in 116 infants. All of them were analyzed. Adverse events occurred in 16.4%: catheter-associated bacteraemia (5.7%), obstruction (5.7%), extravasation (2.1%) and phlebitis (2.1%), < 27 weeks of pregnancy (OR = 1.2, P = .02), birth weight < 1000 g (OR = 6.7, P = .02), with catheters in situ for longer than one week (OR = 9.8, P = .02) and with perfusion of antibiotics per catheter (OR = 1.3, P < .01). Phlebitis is associated with the insertion of the catheter in LL and head (OR = 1.1, P = .03). Factors associated with bacteraemia risk with adjusted prevalence odds ratio are extremely low birth weight neonates (OR = 6.38; P = .03) and with a catheter in situ for longer than one week (OR = 9.41; P = .04). Conclusions: The periodic evaluation of catheter-related adverse events is very useful to prepare improvement plans. This will maximize safety for the most vulnerable newborns, especially those of extremely low birth weight that require very long treatments
Subject(s)
Humans , Male , Female , Infant, Newborn , Central Venous Catheters/adverse effects , Risk Factors , Intensive Care Units, Neonatal/trends , Critical Care/methods , Epidemiology, Descriptive , Bacteremia/complications , Bacteremia/prevention & control , Phlebitis/prevention & control , Confidence IntervalsABSTRACT
BACKGROUND: Peripherally inserted central catheters have become a priority in infants who require long-term intravenous therapy, but their use involves certain risks. OBJECTIVE: The aim of the study was to describe the occurrence of adverse events in newborns with peripherally inserted central catheters and to determine the risk factors associated with them. METHODS: A descriptive cross-sectional study was designed and performed. All neonates with peripherally inserted central catheters from October 1st, 2014 to September 30th, 2015 were included. The adverse events and sociodemographic and clinical variables related to neonates and analyzed catheters were recorded. RESULTS: A total of 140 catheters were placed in 116 infants. All of them were analyzed. Adverse events occurred in 16.4%: catheter-associated bacteraemia (5.7%), obstruction (5.7%), extravasation (2.1%) and phlebitis (2.1%), <27weeks of pregnancy (OR=1.2, P=.02), birth weight <1000g (OR=6.7, P=.02), with catheters in situ for longer than one week (OR=9.8, P=.02) and with perfusion of antibiotics per catheter (OR=1.3, P<.01). Phlebitis is associated with the insertion of the catheter in LL and head (OR=1.1, P=.03). Factors associated with bacteraemia risk with adjusted prevalence odds ratio are extremely low birth weight neonates (OR=6.38; P=.03) and with a catheter in situ for longer than one week (OR=9.41; P=.04). CONCLUSIONS: The periodic evaluation of catheter-related adverse events is very useful to prepare improvement plans. This will maximize safety for the most vulnerable newborns, especially those of extremely low birth weight that require very long treatments.
Subject(s)
Catheterization, Peripheral , Central Venous Catheters/adverse effects , Cross-Sectional Studies , Female , Humans , Infant, Newborn , Male , Risk FactorsABSTRACT
The treatment of patients with dentofacial deformities which include excessive exposure of frontal upper teeth and upper alveolar gum at resting and/or dynamic position of the lips, is a frequent challenge to odontologists, orthodontists, prosthesists and maxillofacial surgeons. This article introduces a joint orthodontic-surgical approach for the functional and esthetic correction of this deformity. Attained results are illustrated by two representative case histories.
