Abstract
Placement of image-guided tunneled and non-tunneled large-bore central venous catheters (CVCs) are common procedures in interventional radiology. Although leukopenia and/or thrombocytopenia are common at the time of placement, the roles these factors may have in subsequent catheter-related infection have yet to be investigated. A single-institution retrospective review was performed in patients who underwent CVC placement in interventional radiology between 11/2018–6/2019. The electronic medical record was used to obtain demographics, procedure details, pre-placement laboratory values, and the subsequent 90-day follow-up. A total of 178 tunneled and non-tunneled CVCs met inclusion criteria during this time period. White blood cell (WBC) and platelet counts were found to be significant risk factors for subsequent infection. Administration of pre-procedure antibiotics was not found to be a significant factor for subsequent infection (p = 0.075). Leukopenia and thrombocytopenia at the time of CVC placement are both risk factors of line infection for tunneled large-bore CVCs. This should lead to the consideration of using a non-tunneled CVC when clinically feasible, or the delayed placement of these catheters until counts recover.
Highlights
Central line-associated bloodstream infections (CLABSIs), previously found to be the third leading cause of hospital-acquired infections, are associated with high morbidity and mortality [1,2]
There is conflicting data regarding an association of neutropenia and thrombocytopenia during the placement of an implantable central venous catheters (CVCs), ports, and the subsequent risk of CLABSI in this population is controversial
Patients were excluded if their catheter was placed in a location other than the interventional radiology angiography suite or by another service, if the catheter was an exchange and not primary placement, if they were younger than 18 years old, had a small-bore catheter placed
Summary
Central line-associated bloodstream infections (CLABSIs), previously found to be the third leading cause of hospital-acquired infections, are associated with high morbidity and mortality [1,2]. Image-guided, large-bore central venous catheters (CVCs) can be placed directly, via the internal jugular, subclavian or femoral veins (non-tunneled), or tunneled through the subcutaneous tissues before entry into a central vein (tunneled central venous catheters). These CVCs are commonly placed by interventional radiologists, for hemodialysis or plasmapheresis, and in the setting of hematologic malignancy, such as for hematopoietic cell transplantation in which preparative myeloablative conditioning results in long-lasting pancytopenia [3]. A study performed in 2007 involving 195 pediatric patients showed a significantly higher rate of early CVC or central venous port removal secondary to CLABSI or other complications in neutropenic patients [5]. A more recent study of 183 pediatric patients did not find an increased risk of early removal of central venous ports in a neutropenic patient [6].
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
