Ultrasound guidance and risk for intravascular catheter-related infections among peripheral arterial catheters: a post-hoc analysis of two large randomized-controlled trials

Background The impact on infectious risk of ultrasound guidance at insertion remains controversial in short-term arterial catheters (ACs). The present study investigated the association between ultrasound guidance (US) during AC insertion and major catheter-related infections (MCRI), catheter-relate...
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Autor*in:	Buetti, Niccolò [verfasserIn] Ruckly, Stéphane [verfasserIn] Lucet, Jean-Christophe [verfasserIn] Bouadma, Lila [verfasserIn] Schwebel, Carole [verfasserIn] Mimoz, Olivier [verfasserIn] Timsit, Jean-François [verfasserIn]

Format:	E-Artikel
Sprache:	Englisch

Erschienen:	2020

Schlagwörter:	Catheter Intravascular Arterial catheter Catheter tip Ultrasound Ultrasound guidance Arterial Catheter-related bloodstream infection, infectious risk

Übergeordnetes Werk:	Enthalten in: Annals of intensive care - Heidelberg : Springer, 2011, 10(2020), 1 vom: 08. Juli
Übergeordnetes Werk:	volume:10 ; year:2020 ; number:1 ; day:08 ; month:07

Links:	Volltext

DOI / URN:	10.1186/s13613-020-00705-4

Katalog-ID:	SPR040279227

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520			\|a Background The impact on infectious risk of ultrasound guidance at insertion remains controversial in short-term arterial catheters (ACs). The present study investigated the association between ultrasound guidance (US) during AC insertion and major catheter-related infections (MCRI), catheter-related bloodstream infections (CR-BSI) or colonization, using univariate and multivariate marginal Cox model for clustered data. The skin colonization at catheter removal was evaluated to explain our results. Results We used individual data from two multicenter randomized-controlled trials (RCTs) that included a total of 3029 patients, 10 ICUs and 3950 ACs. US guidance was used for 386 (9.8%) catheter placements. In the univariate Cox model analysis, AC insertion with US versus without US exhibited similar risks for MCRI (HR 0.86, CI 95% 0.27–2.72, p = 0.79), CR-BSI (HR 0.87, CI 95% 0.20–3.72, p = 0.85) and catheter colonization (HR 1.31, CI 95% 0.92–1.86, p = 0.13). After adjustment on confounders, risks associated with US guidance remained similar versus non-US for MCRI (HR 0.71, CI 95% 0.23–2.24, p = 0.56), CR-BSI (HR 0.71, CI 95% 0.17–3.00, p = 0.63) and catheter colonization (HR 0.92, CI 95% 0.63–1.34, p = 0.67). No differences between US and non-US for MCRI, CR-BSI and colonization were observed according to the insertion site, radial or femoral. At catheter removal, the skin colonization was similar between US and non-US groups (p = 0.69). Conclusions Using the largest dataset ever collected from large multi-centric RCTs conducted with relatively consistent insertion and maintenance catheter protocols, we showed that the risk of infectious complications for ACs inserted under US guidance is not superior compared to those inserted without US guidance. Trial registration These studies were registered within ClinicalTrials.gov (numbers NCT01629550 and NCT 01189682).
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700	1		\|a Timsit, Jean-François \|e verfasserin \|4 aut
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allfields	10.1186/s13613-020-00705-4 doi (DE-627)SPR040279227 (SPR)s13613-020-00705-4-e DE-627 ger DE-627 rakwb eng 610 ASE Buetti, Niccolò verfasserin aut Ultrasound guidance and risk for intravascular catheter-related infections among peripheral arterial catheters: a post-hoc analysis of two large randomized-controlled trials 2020 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background The impact on infectious risk of ultrasound guidance at insertion remains controversial in short-term arterial catheters (ACs). The present study investigated the association between ultrasound guidance (US) during AC insertion and major catheter-related infections (MCRI), catheter-related bloodstream infections (CR-BSI) or colonization, using univariate and multivariate marginal Cox model for clustered data. The skin colonization at catheter removal was evaluated to explain our results. Results We used individual data from two multicenter randomized-controlled trials (RCTs) that included a total of 3029 patients, 10 ICUs and 3950 ACs. US guidance was used for 386 (9.8%) catheter placements. In the univariate Cox model analysis, AC insertion with US versus without US exhibited similar risks for MCRI (HR 0.86, CI 95% 0.27–2.72, p = 0.79), CR-BSI (HR 0.87, CI 95% 0.20–3.72, p = 0.85) and catheter colonization (HR 1.31, CI 95% 0.92–1.86, p = 0.13). After adjustment on confounders, risks associated with US guidance remained similar versus non-US for MCRI (HR 0.71, CI 95% 0.23–2.24, p = 0.56), CR-BSI (HR 0.71, CI 95% 0.17–3.00, p = 0.63) and catheter colonization (HR 0.92, CI 95% 0.63–1.34, p = 0.67). No differences between US and non-US for MCRI, CR-BSI and colonization were observed according to the insertion site, radial or femoral. At catheter removal, the skin colonization was similar between US and non-US groups (p = 0.69). Conclusions Using the largest dataset ever collected from large multi-centric RCTs conducted with relatively consistent insertion and maintenance catheter protocols, we showed that the risk of infectious complications for ACs inserted under US guidance is not superior compared to those inserted without US guidance. Trial registration These studies were registered within ClinicalTrials.gov (numbers NCT01629550 and NCT 01189682). Catheter (dpeaa)DE-He213 Intravascular (dpeaa)DE-He213 Arterial catheter (dpeaa)DE-He213 Catheter tip (dpeaa)DE-He213 Ultrasound (dpeaa)DE-He213 Ultrasound guidance (dpeaa)DE-He213 Arterial (dpeaa)DE-He213 Catheter-related bloodstream infection, infectious risk (dpeaa)DE-He213 Ruckly, Stéphane verfasserin aut Lucet, Jean-Christophe verfasserin aut Bouadma, Lila verfasserin aut Schwebel, Carole verfasserin aut Mimoz, Olivier verfasserin aut Timsit, Jean-François verfasserin aut Enthalten in Annals of intensive care Heidelberg : Springer, 2011 10(2020), 1 vom: 08. Juli (DE-627)664260918 (DE-600)2617094-2 2110-5820 nnns volume:10 year:2020 number:1 day:08 month:07 https://dx.doi.org/10.1186/s13613-020-00705-4 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 10 2020 1 08 07
spelling	10.1186/s13613-020-00705-4 doi (DE-627)SPR040279227 (SPR)s13613-020-00705-4-e DE-627 ger DE-627 rakwb eng 610 ASE Buetti, Niccolò verfasserin aut Ultrasound guidance and risk for intravascular catheter-related infections among peripheral arterial catheters: a post-hoc analysis of two large randomized-controlled trials 2020 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background The impact on infectious risk of ultrasound guidance at insertion remains controversial in short-term arterial catheters (ACs). The present study investigated the association between ultrasound guidance (US) during AC insertion and major catheter-related infections (MCRI), catheter-related bloodstream infections (CR-BSI) or colonization, using univariate and multivariate marginal Cox model for clustered data. The skin colonization at catheter removal was evaluated to explain our results. Results We used individual data from two multicenter randomized-controlled trials (RCTs) that included a total of 3029 patients, 10 ICUs and 3950 ACs. US guidance was used for 386 (9.8%) catheter placements. In the univariate Cox model analysis, AC insertion with US versus without US exhibited similar risks for MCRI (HR 0.86, CI 95% 0.27–2.72, p = 0.79), CR-BSI (HR 0.87, CI 95% 0.20–3.72, p = 0.85) and catheter colonization (HR 1.31, CI 95% 0.92–1.86, p = 0.13). After adjustment on confounders, risks associated with US guidance remained similar versus non-US for MCRI (HR 0.71, CI 95% 0.23–2.24, p = 0.56), CR-BSI (HR 0.71, CI 95% 0.17–3.00, p = 0.63) and catheter colonization (HR 0.92, CI 95% 0.63–1.34, p = 0.67). No differences between US and non-US for MCRI, CR-BSI and colonization were observed according to the insertion site, radial or femoral. At catheter removal, the skin colonization was similar between US and non-US groups (p = 0.69). Conclusions Using the largest dataset ever collected from large multi-centric RCTs conducted with relatively consistent insertion and maintenance catheter protocols, we showed that the risk of infectious complications for ACs inserted under US guidance is not superior compared to those inserted without US guidance. Trial registration These studies were registered within ClinicalTrials.gov (numbers NCT01629550 and NCT 01189682). Catheter (dpeaa)DE-He213 Intravascular (dpeaa)DE-He213 Arterial catheter (dpeaa)DE-He213 Catheter tip (dpeaa)DE-He213 Ultrasound (dpeaa)DE-He213 Ultrasound guidance (dpeaa)DE-He213 Arterial (dpeaa)DE-He213 Catheter-related bloodstream infection, infectious risk (dpeaa)DE-He213 Ruckly, Stéphane verfasserin aut Lucet, Jean-Christophe verfasserin aut Bouadma, Lila verfasserin aut Schwebel, Carole verfasserin aut Mimoz, Olivier verfasserin aut Timsit, Jean-François verfasserin aut Enthalten in Annals of intensive care Heidelberg : Springer, 2011 10(2020), 1 vom: 08. Juli (DE-627)664260918 (DE-600)2617094-2 2110-5820 nnns volume:10 year:2020 number:1 day:08 month:07 https://dx.doi.org/10.1186/s13613-020-00705-4 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 10 2020 1 08 07
allfields_unstemmed	10.1186/s13613-020-00705-4 doi (DE-627)SPR040279227 (SPR)s13613-020-00705-4-e DE-627 ger DE-627 rakwb eng 610 ASE Buetti, Niccolò verfasserin aut Ultrasound guidance and risk for intravascular catheter-related infections among peripheral arterial catheters: a post-hoc analysis of two large randomized-controlled trials 2020 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background The impact on infectious risk of ultrasound guidance at insertion remains controversial in short-term arterial catheters (ACs). The present study investigated the association between ultrasound guidance (US) during AC insertion and major catheter-related infections (MCRI), catheter-related bloodstream infections (CR-BSI) or colonization, using univariate and multivariate marginal Cox model for clustered data. The skin colonization at catheter removal was evaluated to explain our results. Results We used individual data from two multicenter randomized-controlled trials (RCTs) that included a total of 3029 patients, 10 ICUs and 3950 ACs. US guidance was used for 386 (9.8%) catheter placements. In the univariate Cox model analysis, AC insertion with US versus without US exhibited similar risks for MCRI (HR 0.86, CI 95% 0.27–2.72, p = 0.79), CR-BSI (HR 0.87, CI 95% 0.20–3.72, p = 0.85) and catheter colonization (HR 1.31, CI 95% 0.92–1.86, p = 0.13). After adjustment on confounders, risks associated with US guidance remained similar versus non-US for MCRI (HR 0.71, CI 95% 0.23–2.24, p = 0.56), CR-BSI (HR 0.71, CI 95% 0.17–3.00, p = 0.63) and catheter colonization (HR 0.92, CI 95% 0.63–1.34, p = 0.67). No differences between US and non-US for MCRI, CR-BSI and colonization were observed according to the insertion site, radial or femoral. At catheter removal, the skin colonization was similar between US and non-US groups (p = 0.69). Conclusions Using the largest dataset ever collected from large multi-centric RCTs conducted with relatively consistent insertion and maintenance catheter protocols, we showed that the risk of infectious complications for ACs inserted under US guidance is not superior compared to those inserted without US guidance. Trial registration These studies were registered within ClinicalTrials.gov (numbers NCT01629550 and NCT 01189682). Catheter (dpeaa)DE-He213 Intravascular (dpeaa)DE-He213 Arterial catheter (dpeaa)DE-He213 Catheter tip (dpeaa)DE-He213 Ultrasound (dpeaa)DE-He213 Ultrasound guidance (dpeaa)DE-He213 Arterial (dpeaa)DE-He213 Catheter-related bloodstream infection, infectious risk (dpeaa)DE-He213 Ruckly, Stéphane verfasserin aut Lucet, Jean-Christophe verfasserin aut Bouadma, Lila verfasserin aut Schwebel, Carole verfasserin aut Mimoz, Olivier verfasserin aut Timsit, Jean-François verfasserin aut Enthalten in Annals of intensive care Heidelberg : Springer, 2011 10(2020), 1 vom: 08. Juli (DE-627)664260918 (DE-600)2617094-2 2110-5820 nnns volume:10 year:2020 number:1 day:08 month:07 https://dx.doi.org/10.1186/s13613-020-00705-4 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 10 2020 1 08 07
allfieldsGer	10.1186/s13613-020-00705-4 doi (DE-627)SPR040279227 (SPR)s13613-020-00705-4-e DE-627 ger DE-627 rakwb eng 610 ASE Buetti, Niccolò verfasserin aut Ultrasound guidance and risk for intravascular catheter-related infections among peripheral arterial catheters: a post-hoc analysis of two large randomized-controlled trials 2020 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background The impact on infectious risk of ultrasound guidance at insertion remains controversial in short-term arterial catheters (ACs). The present study investigated the association between ultrasound guidance (US) during AC insertion and major catheter-related infections (MCRI), catheter-related bloodstream infections (CR-BSI) or colonization, using univariate and multivariate marginal Cox model for clustered data. The skin colonization at catheter removal was evaluated to explain our results. Results We used individual data from two multicenter randomized-controlled trials (RCTs) that included a total of 3029 patients, 10 ICUs and 3950 ACs. US guidance was used for 386 (9.8%) catheter placements. In the univariate Cox model analysis, AC insertion with US versus without US exhibited similar risks for MCRI (HR 0.86, CI 95% 0.27–2.72, p = 0.79), CR-BSI (HR 0.87, CI 95% 0.20–3.72, p = 0.85) and catheter colonization (HR 1.31, CI 95% 0.92–1.86, p = 0.13). After adjustment on confounders, risks associated with US guidance remained similar versus non-US for MCRI (HR 0.71, CI 95% 0.23–2.24, p = 0.56), CR-BSI (HR 0.71, CI 95% 0.17–3.00, p = 0.63) and catheter colonization (HR 0.92, CI 95% 0.63–1.34, p = 0.67). No differences between US and non-US for MCRI, CR-BSI and colonization were observed according to the insertion site, radial or femoral. At catheter removal, the skin colonization was similar between US and non-US groups (p = 0.69). Conclusions Using the largest dataset ever collected from large multi-centric RCTs conducted with relatively consistent insertion and maintenance catheter protocols, we showed that the risk of infectious complications for ACs inserted under US guidance is not superior compared to those inserted without US guidance. Trial registration These studies were registered within ClinicalTrials.gov (numbers NCT01629550 and NCT 01189682). Catheter (dpeaa)DE-He213 Intravascular (dpeaa)DE-He213 Arterial catheter (dpeaa)DE-He213 Catheter tip (dpeaa)DE-He213 Ultrasound (dpeaa)DE-He213 Ultrasound guidance (dpeaa)DE-He213 Arterial (dpeaa)DE-He213 Catheter-related bloodstream infection, infectious risk (dpeaa)DE-He213 Ruckly, Stéphane verfasserin aut Lucet, Jean-Christophe verfasserin aut Bouadma, Lila verfasserin aut Schwebel, Carole verfasserin aut Mimoz, Olivier verfasserin aut Timsit, Jean-François verfasserin aut Enthalten in Annals of intensive care Heidelberg : Springer, 2011 10(2020), 1 vom: 08. Juli (DE-627)664260918 (DE-600)2617094-2 2110-5820 nnns volume:10 year:2020 number:1 day:08 month:07 https://dx.doi.org/10.1186/s13613-020-00705-4 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 10 2020 1 08 07
allfieldsSound	10.1186/s13613-020-00705-4 doi (DE-627)SPR040279227 (SPR)s13613-020-00705-4-e DE-627 ger DE-627 rakwb eng 610 ASE Buetti, Niccolò verfasserin aut Ultrasound guidance and risk for intravascular catheter-related infections among peripheral arterial catheters: a post-hoc analysis of two large randomized-controlled trials 2020 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background The impact on infectious risk of ultrasound guidance at insertion remains controversial in short-term arterial catheters (ACs). The present study investigated the association between ultrasound guidance (US) during AC insertion and major catheter-related infections (MCRI), catheter-related bloodstream infections (CR-BSI) or colonization, using univariate and multivariate marginal Cox model for clustered data. The skin colonization at catheter removal was evaluated to explain our results. Results We used individual data from two multicenter randomized-controlled trials (RCTs) that included a total of 3029 patients, 10 ICUs and 3950 ACs. US guidance was used for 386 (9.8%) catheter placements. In the univariate Cox model analysis, AC insertion with US versus without US exhibited similar risks for MCRI (HR 0.86, CI 95% 0.27–2.72, p = 0.79), CR-BSI (HR 0.87, CI 95% 0.20–3.72, p = 0.85) and catheter colonization (HR 1.31, CI 95% 0.92–1.86, p = 0.13). After adjustment on confounders, risks associated with US guidance remained similar versus non-US for MCRI (HR 0.71, CI 95% 0.23–2.24, p = 0.56), CR-BSI (HR 0.71, CI 95% 0.17–3.00, p = 0.63) and catheter colonization (HR 0.92, CI 95% 0.63–1.34, p = 0.67). No differences between US and non-US for MCRI, CR-BSI and colonization were observed according to the insertion site, radial or femoral. At catheter removal, the skin colonization was similar between US and non-US groups (p = 0.69). Conclusions Using the largest dataset ever collected from large multi-centric RCTs conducted with relatively consistent insertion and maintenance catheter protocols, we showed that the risk of infectious complications for ACs inserted under US guidance is not superior compared to those inserted without US guidance. Trial registration These studies were registered within ClinicalTrials.gov (numbers NCT01629550 and NCT 01189682). Catheter (dpeaa)DE-He213 Intravascular (dpeaa)DE-He213 Arterial catheter (dpeaa)DE-He213 Catheter tip (dpeaa)DE-He213 Ultrasound (dpeaa)DE-He213 Ultrasound guidance (dpeaa)DE-He213 Arterial (dpeaa)DE-He213 Catheter-related bloodstream infection, infectious risk (dpeaa)DE-He213 Ruckly, Stéphane verfasserin aut Lucet, Jean-Christophe verfasserin aut Bouadma, Lila verfasserin aut Schwebel, Carole verfasserin aut Mimoz, Olivier verfasserin aut Timsit, Jean-François verfasserin aut Enthalten in Annals of intensive care Heidelberg : Springer, 2011 10(2020), 1 vom: 08. Juli (DE-627)664260918 (DE-600)2617094-2 2110-5820 nnns volume:10 year:2020 number:1 day:08 month:07 https://dx.doi.org/10.1186/s13613-020-00705-4 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 10 2020 1 08 07
language	English
source	Enthalten in Annals of intensive care 10(2020), 1 vom: 08. Juli volume:10 year:2020 number:1 day:08 month:07
sourceStr	Enthalten in Annals of intensive care 10(2020), 1 vom: 08. Juli volume:10 year:2020 number:1 day:08 month:07
format_phy_str_mv	Article
institution	findex.gbv.de
topic_facet	Catheter Intravascular Arterial catheter Catheter tip Ultrasound Ultrasound guidance Arterial Catheter-related bloodstream infection, infectious risk
dewey-raw	610
isfreeaccess_bool	true
container_title	Annals of intensive care
authorswithroles_txt_mv	Buetti, Niccolò @@aut@@ Ruckly, Stéphane @@aut@@ Lucet, Jean-Christophe @@aut@@ Bouadma, Lila @@aut@@ Schwebel, Carole @@aut@@ Mimoz, Olivier @@aut@@ Timsit, Jean-François @@aut@@
publishDateDaySort_date	2020-07-08T00:00:00Z
hierarchy_top_id	664260918
dewey-sort	3610
id	SPR040279227
language_de	englisch
fullrecord	<?xml version="1.0" encoding="UTF-8"?><collection xmlns="http://www.loc.gov/MARC21/slim"><record><leader>01000caa a22002652 4500</leader><controlfield tag="001">SPR040279227</controlfield><controlfield tag="003">DE-627</controlfield><controlfield tag="005">20230519173141.0</controlfield><controlfield tag="007">cr uuu---uuuuu</controlfield><controlfield tag="008">201007s2020 xx \|\|\|\|\|o 00\| \|\|eng c</controlfield><datafield tag="024" ind1="7" ind2=" "><subfield code="a">10.1186/s13613-020-00705-4</subfield><subfield code="2">doi</subfield></datafield><datafield tag="035" ind1=" " ind2=" "><subfield code="a">(DE-627)SPR040279227</subfield></datafield><datafield tag="035" ind1=" " ind2=" "><subfield code="a">(SPR)s13613-020-00705-4-e</subfield></datafield><datafield tag="040" ind1=" " ind2=" "><subfield code="a">DE-627</subfield><subfield code="b">ger</subfield><subfield code="c">DE-627</subfield><subfield code="e">rakwb</subfield></datafield><datafield tag="041" ind1=" " ind2=" "><subfield code="a">eng</subfield></datafield><datafield tag="082" ind1="0" ind2="4"><subfield code="a">610</subfield><subfield code="q">ASE</subfield></datafield><datafield tag="100" ind1="1" ind2=" "><subfield code="a">Buetti, Niccolò</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="245" ind1="1" ind2="0"><subfield code="a">Ultrasound guidance and risk for intravascular catheter-related infections among peripheral arterial catheters: a post-hoc analysis of two large randomized-controlled trials</subfield></datafield><datafield tag="264" ind1=" " ind2="1"><subfield code="c">2020</subfield></datafield><datafield tag="336" ind1=" " ind2=" "><subfield code="a">Text</subfield><subfield code="b">txt</subfield><subfield code="2">rdacontent</subfield></datafield><datafield tag="337" ind1=" " ind2=" "><subfield code="a">Computermedien</subfield><subfield code="b">c</subfield><subfield code="2">rdamedia</subfield></datafield><datafield tag="338" ind1=" " ind2=" "><subfield code="a">Online-Ressource</subfield><subfield code="b">cr</subfield><subfield code="2">rdacarrier</subfield></datafield><datafield tag="520" ind1=" " ind2=" "><subfield code="a">Background The impact on infectious risk of ultrasound guidance at insertion remains controversial in short-term arterial catheters (ACs). The present study investigated the association between ultrasound guidance (US) during AC insertion and major catheter-related infections (MCRI), catheter-related bloodstream infections (CR-BSI) or colonization, using univariate and multivariate marginal Cox model for clustered data. The skin colonization at catheter removal was evaluated to explain our results. Results We used individual data from two multicenter randomized-controlled trials (RCTs) that included a total of 3029 patients, 10 ICUs and 3950 ACs. US guidance was used for 386 (9.8%) catheter placements. In the univariate Cox model analysis, AC insertion with US versus without US exhibited similar risks for MCRI (HR 0.86, CI 95% 0.27–2.72, p = 0.79), CR-BSI (HR 0.87, CI 95% 0.20–3.72, p = 0.85) and catheter colonization (HR 1.31, CI 95% 0.92–1.86, p = 0.13). After adjustment on confounders, risks associated with US guidance remained similar versus non-US for MCRI (HR 0.71, CI 95% 0.23–2.24, p = 0.56), CR-BSI (HR 0.71, CI 95% 0.17–3.00, p = 0.63) and catheter colonization (HR 0.92, CI 95% 0.63–1.34, p = 0.67). No differences between US and non-US for MCRI, CR-BSI and colonization were observed according to the insertion site, radial or femoral. At catheter removal, the skin colonization was similar between US and non-US groups (p = 0.69). Conclusions Using the largest dataset ever collected from large multi-centric RCTs conducted with relatively consistent insertion and maintenance catheter protocols, we showed that the risk of infectious complications for ACs inserted under US guidance is not superior compared to those inserted without US guidance. 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author	Buetti, Niccolò
spellingShingle	Buetti, Niccolò ddc 610 misc Catheter misc Intravascular misc Arterial catheter misc Catheter tip misc Ultrasound misc Ultrasound guidance misc Arterial misc Catheter-related bloodstream infection, infectious risk Ultrasound guidance and risk for intravascular catheter-related infections among peripheral arterial catheters: a post-hoc analysis of two large randomized-controlled trials
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topic_title	610 ASE Ultrasound guidance and risk for intravascular catheter-related infections among peripheral arterial catheters: a post-hoc analysis of two large randomized-controlled trials Catheter (dpeaa)DE-He213 Intravascular (dpeaa)DE-He213 Arterial catheter (dpeaa)DE-He213 Catheter tip (dpeaa)DE-He213 Ultrasound (dpeaa)DE-He213 Ultrasound guidance (dpeaa)DE-He213 Arterial (dpeaa)DE-He213 Catheter-related bloodstream infection, infectious risk (dpeaa)DE-He213
topic	ddc 610 misc Catheter misc Intravascular misc Arterial catheter misc Catheter tip misc Ultrasound misc Ultrasound guidance misc Arterial misc Catheter-related bloodstream infection, infectious risk
topic_unstemmed	ddc 610 misc Catheter misc Intravascular misc Arterial catheter misc Catheter tip misc Ultrasound misc Ultrasound guidance misc Arterial misc Catheter-related bloodstream infection, infectious risk
topic_browse	ddc 610 misc Catheter misc Intravascular misc Arterial catheter misc Catheter tip misc Ultrasound misc Ultrasound guidance misc Arterial misc Catheter-related bloodstream infection, infectious risk
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title	Ultrasound guidance and risk for intravascular catheter-related infections among peripheral arterial catheters: a post-hoc analysis of two large randomized-controlled trials
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title_full	Ultrasound guidance and risk for intravascular catheter-related infections among peripheral arterial catheters: a post-hoc analysis of two large randomized-controlled trials
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author_browse	Buetti, Niccolò Ruckly, Stéphane Lucet, Jean-Christophe Bouadma, Lila Schwebel, Carole Mimoz, Olivier Timsit, Jean-François
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title_sort	ultrasound guidance and risk for intravascular catheter-related infections among peripheral arterial catheters: a post-hoc analysis of two large randomized-controlled trials
title_auth	Ultrasound guidance and risk for intravascular catheter-related infections among peripheral arterial catheters: a post-hoc analysis of two large randomized-controlled trials
abstract	Background The impact on infectious risk of ultrasound guidance at insertion remains controversial in short-term arterial catheters (ACs). The present study investigated the association between ultrasound guidance (US) during AC insertion and major catheter-related infections (MCRI), catheter-related bloodstream infections (CR-BSI) or colonization, using univariate and multivariate marginal Cox model for clustered data. The skin colonization at catheter removal was evaluated to explain our results. Results We used individual data from two multicenter randomized-controlled trials (RCTs) that included a total of 3029 patients, 10 ICUs and 3950 ACs. US guidance was used for 386 (9.8%) catheter placements. In the univariate Cox model analysis, AC insertion with US versus without US exhibited similar risks for MCRI (HR 0.86, CI 95% 0.27–2.72, p = 0.79), CR-BSI (HR 0.87, CI 95% 0.20–3.72, p = 0.85) and catheter colonization (HR 1.31, CI 95% 0.92–1.86, p = 0.13). After adjustment on confounders, risks associated with US guidance remained similar versus non-US for MCRI (HR 0.71, CI 95% 0.23–2.24, p = 0.56), CR-BSI (HR 0.71, CI 95% 0.17–3.00, p = 0.63) and catheter colonization (HR 0.92, CI 95% 0.63–1.34, p = 0.67). No differences between US and non-US for MCRI, CR-BSI and colonization were observed according to the insertion site, radial or femoral. At catheter removal, the skin colonization was similar between US and non-US groups (p = 0.69). Conclusions Using the largest dataset ever collected from large multi-centric RCTs conducted with relatively consistent insertion and maintenance catheter protocols, we showed that the risk of infectious complications for ACs inserted under US guidance is not superior compared to those inserted without US guidance. Trial registration These studies were registered within ClinicalTrials.gov (numbers NCT01629550 and NCT 01189682).
abstractGer	Background The impact on infectious risk of ultrasound guidance at insertion remains controversial in short-term arterial catheters (ACs). The present study investigated the association between ultrasound guidance (US) during AC insertion and major catheter-related infections (MCRI), catheter-related bloodstream infections (CR-BSI) or colonization, using univariate and multivariate marginal Cox model for clustered data. The skin colonization at catheter removal was evaluated to explain our results. Results We used individual data from two multicenter randomized-controlled trials (RCTs) that included a total of 3029 patients, 10 ICUs and 3950 ACs. US guidance was used for 386 (9.8%) catheter placements. In the univariate Cox model analysis, AC insertion with US versus without US exhibited similar risks for MCRI (HR 0.86, CI 95% 0.27–2.72, p = 0.79), CR-BSI (HR 0.87, CI 95% 0.20–3.72, p = 0.85) and catheter colonization (HR 1.31, CI 95% 0.92–1.86, p = 0.13). After adjustment on confounders, risks associated with US guidance remained similar versus non-US for MCRI (HR 0.71, CI 95% 0.23–2.24, p = 0.56), CR-BSI (HR 0.71, CI 95% 0.17–3.00, p = 0.63) and catheter colonization (HR 0.92, CI 95% 0.63–1.34, p = 0.67). No differences between US and non-US for MCRI, CR-BSI and colonization were observed according to the insertion site, radial or femoral. At catheter removal, the skin colonization was similar between US and non-US groups (p = 0.69). Conclusions Using the largest dataset ever collected from large multi-centric RCTs conducted with relatively consistent insertion and maintenance catheter protocols, we showed that the risk of infectious complications for ACs inserted under US guidance is not superior compared to those inserted without US guidance. Trial registration These studies were registered within ClinicalTrials.gov (numbers NCT01629550 and NCT 01189682).
abstract_unstemmed	Background The impact on infectious risk of ultrasound guidance at insertion remains controversial in short-term arterial catheters (ACs). The present study investigated the association between ultrasound guidance (US) during AC insertion and major catheter-related infections (MCRI), catheter-related bloodstream infections (CR-BSI) or colonization, using univariate and multivariate marginal Cox model for clustered data. The skin colonization at catheter removal was evaluated to explain our results. Results We used individual data from two multicenter randomized-controlled trials (RCTs) that included a total of 3029 patients, 10 ICUs and 3950 ACs. US guidance was used for 386 (9.8%) catheter placements. In the univariate Cox model analysis, AC insertion with US versus without US exhibited similar risks for MCRI (HR 0.86, CI 95% 0.27–2.72, p = 0.79), CR-BSI (HR 0.87, CI 95% 0.20–3.72, p = 0.85) and catheter colonization (HR 1.31, CI 95% 0.92–1.86, p = 0.13). After adjustment on confounders, risks associated with US guidance remained similar versus non-US for MCRI (HR 0.71, CI 95% 0.23–2.24, p = 0.56), CR-BSI (HR 0.71, CI 95% 0.17–3.00, p = 0.63) and catheter colonization (HR 0.92, CI 95% 0.63–1.34, p = 0.67). No differences between US and non-US for MCRI, CR-BSI and colonization were observed according to the insertion site, radial or femoral. At catheter removal, the skin colonization was similar between US and non-US groups (p = 0.69). Conclusions Using the largest dataset ever collected from large multi-centric RCTs conducted with relatively consistent insertion and maintenance catheter protocols, we showed that the risk of infectious complications for ACs inserted under US guidance is not superior compared to those inserted without US guidance. Trial registration These studies were registered within ClinicalTrials.gov (numbers NCT01629550 and NCT 01189682).
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title_short	Ultrasound guidance and risk for intravascular catheter-related infections among peripheral arterial catheters: a post-hoc analysis of two large randomized-controlled trials
url	https://dx.doi.org/10.1186/s13613-020-00705-4
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author2	Ruckly, Stéphane Lucet, Jean-Christophe Bouadma, Lila Schwebel, Carole Mimoz, Olivier Timsit, Jean-François
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Ultrasound guidance and risk for intravascular catheter-related infections among peripheral arterial catheters: a post-hoc analysis of two large randomized-controlled trials

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