Estudio prospectivo sobre catéteres epicutáneos en neonatos. Grupo de Hospitales Castrillo
Prospective Evaluation of Percutaneous Central Venous Silastic Catheters in Newborn Infants"Castrillo" Hospital Group
J.B. López Sastre
, B. Fernández Colomer, G.D. Coto Cotallo, A. Ramos Aparicio
Autor para correspondencia
jsastre@hca.es
Correspondencia: Servicio de Neonatología.Hospital Central de Asturias.Celestino Villamil,s/n.33006 Ovied.Asturias.
Correspondencia: Servicio de Neonatología.Hospital Central de Asturias.Celestino Villamil,s/n.33006 Ovied.Asturias.
Coordinadores. Hospital Central de Asturias. Oviedo
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Ramos Aparicio" "autores" => array:4 [ 0 => array:4 [ "nombre" => "J.B." "apellidos" => "López Sastre" "email" => array:1 [ 0 => "jsastre@hca.es" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "B." "apellidos" => "Fernández Colomer" ] 2 => array:2 [ "nombre" => "G.D." "apellidos" => "Coto Cotallo" ] 3 => array:2 [ "nombre" => "A." "apellidos" => "Ramos Aparicio" ] ] "afiliaciones" => array:1 [ 0 => array:1 [ "entidad" => "Coordinadores. Hospital Central de Asturias. Oviedo" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "*" "correspondencia" => "Correspondencia: Servicio de Neonatología.Hospital Central de Asturias.Celestino Villamil,s/n.33006 Ovied.Asturias." ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Prospective Evaluation of Percutaneous Central Venous Silastic Catheters in Newborn Infants"Castrillo" Hospital Group" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2000-03-31" "fechaAceptado" => "2000-05-31" "PalabrasClave" => array:2 [ "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec186407" "palabras" => array:8 [ 0 => "Canalización venosa central" 1 => "Silicona" 2 => "Neonato" 3 => "Facto-res de riesgo" 4 => "Sepsis" 5 => "Staphylococcus epidermidis" 6 => "Estu-dios prospectivos" 7 => "Análisis multivariante" ] ] ] "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec186408" "palabras" => array:10 [ 0 => "Central venous catheterization" 1 => "Silicone elastomers" 2 => "Newborn infant" 3 => "Risk factors" 4 => "Sepsis" 5 => "Staphylococcus epi-dermidis" 6 => "Prospective studies" 7 => "Multivarite analysis" 8 => "Cat-heters" 9 => "Iindwelling" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "es" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Objetivos</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Conocer la situación actual en nuestro país sobre el empleo de catéteres epicutáneos en neonatos, analizando ca-racterísticas técnicas y complicaciones infecciosas, mecánicas y locales.</p> <span class="elsevierStyleSectionTitle">Métodos</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Entre el 15/7/97 y el 31/12/98, en los servicios de neonatología de los hospitales integrantes del Grupo de Hospitales Castrillo se recogieron de forma prospectiva para su análisis los catéteres epicutáneos colocados en recién nacidos (RN). Cada hospital escogía la duración del período durante el cual se recogían los catéteres, pero se impuso la condición de que durante este tiempo se debían estudiar todos los catéteres colocados.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Se han analizado 939 catéteres epicutáneocava, colocados en 787 RN, totalizando 8.073 días-catéter. De ellos, 826 (88%) se colocaron a través de venas de extremidad superior, 82 (8,7%) a través de venas de extremidad infe-rior y 31 (3,3%) a través de venas del cuero cabelludo. Fueron colocados en neonatos con amplia variedad de pesos y edades gestacionales, insertándose la mayoría en la primera semana de vida y permaneciendo una media de 7 días (máximo 55 días). Se utilizaron principalmente catéteres de silicona (96,8%) siendo su colocación poco dificultosa (un 58,7% al primer intento). La mayoría se re-tiraron electivamente (61,5%). Se realizó cultivo de lapunta en 872 catéteres (92,8%) y de ellos, 219 (25,1%) es-taban colonizados. Entre los colonizados, 178 presenta-ban contaminación del catéter y en 41 se confirmó sep-sis relacionada con catéter (SRC). La incidencia de con-taminación fue del 20,4% (178/872) y de sepsis cierta relacionada con catéter del 4,7% (41/872). Para los 7.744días-catéter de estos 872, la densidad de incidencia fue de 23 y 5,3 por 1.000 días-catéter para contaminación y sep-sis, respectivamente. En la etiología de contaminación y SRC predominaron gérmenes grampositivos, destacando S. epidermidis(71,7 y 50%, respectivamente). En 205 ca-téteres aparecieron complicaciones locales o mecánicas, siendo la más frecuente la flebitis (9,5%), sobre todo en catéteres colocados en extremidad inferior. La obstruc-ción, la extravasación y la rotura fueron complicaciones infrecuentes.</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">La utilización de catéteres epicutáneos es una práctica habitual en las UCIN de nuestro país. Es una técnica de ac-ceso venoso, fácil, segura y eficaz para la administración prolongada de soluciones intravenosas, siendo el princi-pal problema derivado de su uso las infecciones, sobre to-do las SRC originadas por S. epidermidis.</p>" ] "en" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Objective</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">To evaluate the current use of percutaneous central ve-nous silastic catheters in newborn infants in Spain by analysing technical characteristics and infections, as well as mechanical and local complications.</p> <span class="elsevierStyleSectionTitle">Methods</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Percutaneous central venous catheters inserted in new-borns in the neonatal units of the hospitals in the "Cas-trillo Hospital Group" from July 15, 1998 to December 31, 1998 were collected for prospective analysis. Each hospi-tal was able to chose the length of the period of catheter data collection on condition that all inserted catheters were studied during the period.</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">A total of 939 percutaneous venous catheters, inserted in 787 newborn infants, and representing a total of 8073 cathe-ter-days, were analysed. Of these, 823 (88%) were inserted in upper extremity veins, 82 (8.7%) in lower extremity veins, and 31 (3.3%) in scalp veins. Catheterizations were perfor-med in newborn infants with a wide range of weights and gestational ages, in most cases during the first week of life and with an average indwelling time of 7 days (55 days maxi-mum). Silicone elastomer catheters were mainly used (96.8%), because of the ease of their placement (58.7% at the first attempt). Most were electively removed (61.5%). A total of 872 (92.8%) catheter tips were sent for microbiological exa-mination and 219 (25.1%) yielded positives cultures (catheter colonization). Of these, 178 had catheter contamination and in 41 catheter-related sepsis (CRS) was confirmed. The inci-dence of catheter contamination was 20.4% (178/872) and was 4.7% for CRS (41/872). The density of incidence was 23 and 5.3 for each 1000 catheter-days respectively. The most common organisms isolated were Gram-positive, especially Staphylococcus epidermidisorganisms (71.1% and 50% for contamination and CRS respectively). Local or mechanical complications were documented in 205 catheters, phlebitis being the most common (9.5%), especially after inserting cat-heters through low extremity veins; occlusion, extravasation of fluid and catheter breakage were rare complications.</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">The placement of percutaneous venous catheters is common in Spanish neonatal units. This is an easy, safe and effective technique for prolonged intravenous the-rapy. The main problem is infection, particularly CRS caused by Staphylococcus epidermidis.</p>" ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara">Hospitales participantes: Hospital General de Galicia. Santiago (J.M. Fraga Bermúdez, J.R. Fernández Lorenzo). Hospital del Bierzo. Ponferrada (I. Fidalgo). Complejo Hospitalario de León (E. Álvaro). Hospital Clínico de Valladolid (M.P. Aragón García). Hospital del Río Hortega. Valladolid (C. González Armengod). Hospital Clínico de Salamanca (M.C. Pedraz García). Hospital S.S. Segovia (A. Urbón Artero). Hospital General Yagüe. Burgos (P. Aparicio Lozano). Hospital de Cruces. Bilbao (A. Cotero Lavín). Hospital Ntra. Sra. Aránzazu. San Sebastián (L. Paisán Grisolía). Hospital Clínico de Zaragoza (J. Pérez González). Hospital Clínico San Carlos. Madrid (M. Moro Serrano). Hospital Gregorio Marañón. Madrid (M. Sánchez Luna). Hospital La Paz. Madrid (J. Quero Jiménez, S. Salas Hernández). Hospital Clínico y Casa Maternidad. Barcelona (X. Carbonell Estrany, J. Figueras Aloy). Hospital San Juan de Dios. Barcelona (X. Krauel i Vidal. M. Iriondo Sanz). Instituto Dexeus. Barcelona (R. Baraibar Castelló). Hospital La Fe. Valencia (V. Roqués Serradilla). Hospital S.S. Jerez (J. Ortiz Tardío). Hospital Materno Infantil-Clínico Universitario. Málaga (M. García del Río). Hospital Virgen de las Nieves. Granada (M. Samaniego Muñoz). Hospital Clínico de Granada (E. Narbona López). Hospital Clínico Sta. Cruz de Tenerife (E. Domenech Martínez).</p>" ] ] "bibliografia" => array:2 [ "titulo" => "Bibliografía" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:43 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Parenteral nutrition in the management of sick low birth weight infants" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "J.C.L. Shaw" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Pediatr Clin North Am" "fecha" => "1973" "volumen" => "20" "paginaInicial" => "333" "paginaFinal" => "358" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2." 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| año/Mes | Html | Total | |
|---|---|---|---|
| 2024 Noviembre | 8 | 14 | 22 |
| 2024 Octubre | 79 | 54 | 133 |
| 2024 Septiembre | 90 | 50 | 140 |
| 2024 Agosto | 107 | 91 | 198 |
| 2024 Julio | 68 | 48 | 116 |
| 2024 Junio | 79 | 28 | 107 |
| 2024 Mayo | 80 | 46 | 126 |
| 2024 Abril | 58 | 49 | 107 |
| 2024 Marzo | 39 | 43 | 82 |
| 2024 Febrero | 30 | 48 | 78 |
| 2024 Enero | 28 | 38 | 66 |
| 2023 Diciembre | 42 | 19 | 61 |
| 2023 Noviembre | 31 | 59 | 90 |
| 2023 Octubre | 30 | 30 | 60 |
| 2023 Septiembre | 29 | 26 | 55 |
| 2023 Agosto | 32 | 25 | 57 |
| 2023 Julio | 28 | 46 | 74 |
| 2023 Junio | 32 | 36 | 68 |
| 2023 Mayo | 34 | 41 | 75 |
| 2023 Abril | 25 | 26 | 51 |
| 2023 Marzo | 23 | 34 | 57 |
| 2023 Febrero | 18 | 25 | 43 |
| 2023 Enero | 11 | 31 | 42 |
| 2022 Diciembre | 22 | 33 | 55 |
| 2022 Noviembre | 34 | 37 | 71 |
| 2022 Octubre | 26 | 56 | 82 |
| 2022 Septiembre | 33 | 33 | 66 |
| 2022 Agosto | 25 | 45 | 70 |
| 2022 Julio | 20 | 53 | 73 |
| 2022 Junio | 32 | 39 | 71 |
| 2022 Mayo | 23 | 43 | 66 |
| 2022 Abril | 34 | 53 | 87 |
| 2022 Marzo | 28 | 44 | 72 |
| 2022 Febrero | 23 | 31 | 54 |
| 2022 Enero | 21 | 42 | 63 |
| 2021 Diciembre | 18 | 53 | 71 |
| 2021 Noviembre | 26 | 39 | 65 |
| 2021 Octubre | 74 | 74 | 148 |
| 2021 Septiembre | 39 | 52 | 91 |
| 2021 Agosto | 34 | 23 | 57 |
| 2021 Julio | 41 | 35 | 76 |
| 2021 Junio | 33 | 70 | 103 |
| 2021 Mayo | 47 | 25 | 72 |
| 2021 Abril | 84 | 45 | 129 |
| 2021 Marzo | 72 | 20 | 92 |
| 2021 Febrero | 79 | 18 | 97 |
| 2021 Enero | 65 | 17 | 82 |
| 2020 Diciembre | 44 | 17 | 61 |
| 2020 Noviembre | 27 | 19 | 46 |
| 2020 Octubre | 30 | 20 | 50 |
| 2020 Septiembre | 27 | 7 | 34 |
| 2020 Agosto | 31 | 8 | 39 |
| 2020 Julio | 27 | 11 | 38 |
| 2020 Junio | 26 | 14 | 40 |
| 2020 Mayo | 46 | 14 | 60 |
| 2020 Abril | 49 | 13 | 62 |
| 2020 Marzo | 35 | 9 | 44 |
| 2020 Febrero | 37 | 17 | 54 |
| 2020 Enero | 43 | 18 | 61 |
| 2019 Diciembre | 57 | 18 | 75 |
| 2019 Noviembre | 30 | 7 | 37 |
| 2019 Octubre | 11 | 12 | 23 |
| 2019 Septiembre | 24 | 20 | 44 |
| 2019 Agosto | 27 | 16 | 43 |
| 2019 Julio | 27 | 9 | 36 |
| 2019 Junio | 28 | 25 | 53 |
| 2019 Mayo | 44 | 36 | 80 |
| 2019 Abril | 54 | 16 | 70 |
| 2019 Marzo | 28 | 21 | 49 |
| 2019 Febrero | 24 | 17 | 41 |
| 2019 Enero | 25 | 12 | 37 |
| 2018 Diciembre | 30 | 12 | 42 |
| 2018 Noviembre | 29 | 18 | 47 |
| 2018 Octubre | 27 | 12 | 39 |
| 2018 Septiembre | 19 | 1 | 20 |
| 2018 Agosto | 1 | 0 | 1 |
| 2018 Julio | 3 | 0 | 3 |
| 2018 Mayo | 2 | 0 | 2 |
| 2018 Abril | 17 | 0 | 17 |
| 2018 Marzo | 10 | 0 | 10 |
| 2018 Febrero | 7 | 0 | 7 |
| 2018 Enero | 14 | 0 | 14 |
| 2017 Diciembre | 4 | 0 | 4 |
| 2017 Noviembre | 18 | 0 | 18 |
| 2017 Octubre | 8 | 0 | 8 |
| 2017 Septiembre | 10 | 0 | 10 |
| 2017 Agosto | 12 | 0 | 12 |
| 2017 Julio | 13 | 0 | 13 |
| 2017 Junio | 27 | 10 | 37 |
| 2017 Mayo | 24 | 7 | 31 |
| 2017 Abril | 17 | 4 | 21 |
| 2017 Marzo | 21 | 4 | 25 |
| 2017 Febrero | 7 | 3 | 10 |
| 2017 Enero | 9 | 3 | 12 |
| 2016 Diciembre | 59 | 6 | 65 |
| 2016 Noviembre | 84 | 10 | 94 |
| 2016 Octubre | 61 | 6 | 67 |
| 2016 Septiembre | 65 | 4 | 69 |
| 2016 Agosto | 43 | 6 | 49 |
| 2016 Julio | 25 | 2 | 27 |
| 2016 Junio | 5 | 0 | 5 |
| 2016 Mayo | 1 | 0 | 1 |
| 2016 Abril | 3 | 0 | 3 |
| 2016 Marzo | 7 | 0 | 7 |
| 2016 Febrero | 4 | 0 | 4 |
| 2015 Diciembre | 4 | 0 | 4 |
| 2015 Noviembre | 1 | 0 | 1 |
| 2015 Octubre | 4 | 11 | 15 |
| 2015 Septiembre | 4 | 7 | 11 |
| 2015 Agosto | 4 | 0 | 4 |
| 2015 Julio | 12 | 9 | 21 |
| 2015 Junio | 11 | 1 | 12 |
| 2015 Mayo | 14 | 1 | 15 |
| 2015 Abril | 15 | 8 | 23 |
| 2015 Marzo | 7 | 0 | 7 |
| 2015 Febrero | 6 | 5 | 11 |
| 2015 Enero | 15 | 0 | 15 |
| 2014 Diciembre | 12 | 1 | 13 |
| 2014 Noviembre | 15 | 0 | 15 |
| 2014 Octubre | 14 | 0 | 14 |
| 2014 Septiembre | 15 | 4 | 19 |
| 2014 Agosto | 20 | 2 | 22 |
| 2014 Julio | 18 | 1 | 19 |
| 2014 Junio | 18 | 1 | 19 |
| 2014 Mayo | 30 | 1 | 31 |
| 2014 Abril | 34 | 5 | 39 |
| 2014 Marzo | 20 | 7 | 27 |
| 2014 Febrero | 20 | 9 | 29 |
| 2014 Enero | 10 | 12 | 22 |
| 2013 Diciembre | 29 | 10 | 39 |
| 2013 Noviembre | 38 | 8 | 46 |
| 2013 Octubre | 71 | 9 | 80 |
| 2013 Septiembre | 89 | 18 | 107 |
| 2013 Agosto | 27 | 10 | 37 |
| 2013 Julio | 9 | 5 | 14 |
| 2013 Junio | 2 | 2 | 4 |
| 2013 Mayo | 2 | 0 | 2 |
| 2013 Abril | 7 | 2 | 9 |
| 2013 Marzo | 5 | 1 | 6 |
| 2013 Febrero | 22 | 2 | 24 |
| 2013 Enero | 19 | 2 | 21 |
| 2012 Diciembre | 15 | 2 | 17 |
| 2012 Noviembre | 27 | 4 | 31 |
| 2012 Octubre | 21 | 1 | 22 |
| 2012 Septiembre | 2 | 0 | 2 |
| 2012 Agosto | 1 | 1 | 2 |
| 2000 Julio | 5287 | 0 | 5287 |
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