L Nikfarid , N Khogasteh , A Ghanbarian ,
Volume 12, Issue 1 (5-2006)
Abstract
Background & Aim: Peripherally intravenous catheters (PIVs) are an important part of therapy for hospitalized children. Although such catheters provide necessary vascular access, their use puts patients at risk for local and systemic infectious complications with serious morbidity. Migration of skin organisms at the insertion site into the coetaneous catheter tract with colonization of the catheter tip is the most common rout of infection for peripherally inserted catheters in adults but in children this is controversial. The objective of this study is to find any relationship between colonization and catheter-related consequences.
Methods & Materials: In a descriptive cross-sectional study, 108 catheters of children and neonates hospitalized in NICU and infectious ward of Markaz Tebby Kodakan were cultured at a 2-month period. For all cases, a questionnaire of demographic characteristics and information about catheterization including location, dwell time, drugs and total parental nutrition was filled. The condition of catheterization for all cases was the same. Presence of only one colony was considered as positive colonization. Finally the data were analyzed by SPSS software.
Results: Excluding one case because of positive blood culture, from 107 catheters, 36 were colonized (33.6% of cases). Coagulate negative staphylococcus was the most common pathogen seen in 50% of total positive cases. Although there was a clinically significance between the dwell time of catheter and colonization but there was not any statistical significant association between colonization and any other variables including sex, age, hospitalization time, ward, location of catheter, dwell time, infusion of parental nutrition, and the administered drug.
Conclusion: This study is consistent with guidelines of CDC about avoiding unnecessarily routine replacement of catheters in neonates and children. As the risk of infection did not increase in association with dwell time of peripheral venous catheters, it seems it is better to leave catheters in place until there is a sign of local infection or infiltration.
Sohbat Safaie, Seyedeh Fatemeh Ghasemi, Fatemeh Valizadeh, Rasool Mohammadi,
Volume 29, Issue 3 (10-2023)
Abstract
Background & Aim: Pressure ulcers pose a serious and anticipated challenge within the health system. The present study aimed to determine the incidence of pressure ulcer and associated factors among children and newborns.
Methods & Materials: In this cohort study a sample size of 1025 children aged 0 to 14 years hospitalized in two medical training centers affiliated with Kermanshah University of Medical Sciences, were included. The sampling method employed was convenience sampling, conducted between March and July 2022. The data collection tools utilized in this study included a demographic information questionnaire, the Glasgow Coma Scale, National Pressure Ulcer Counseling Association classification, and Braden Q Scale. The data was analyzed using both univariate and multivariate logistic regression analyses.
Results: The incidence rate of pressure ulcers was found to be 4.97% (51 people). In terms of severity, the majority of pressure ulcers were categorized as first grade, accounting for 82.14% (46 people), with the hand area being the most frequently affected site of ulceration, representing 35.71% (20 people). The factors exhibited a significantly higher relative risk of pressure ulcers in children and infants included consciousness level of less than 14 (RR=6.07, 2.90-12.73: 95%CI), hospitalization duration of more than five days (RR=1.08, 1.05-1.12: 95%CI), presence of respiratory problems (RR=2.17, 1.19-3.94: 95%CI), immobility (RR=6.46, 3.44-12.13: 95% CI), utilization of NCPAP mask (RR=1.11, 1.05-1.18: 95% CI), and pulse oximeter (RR=6.07, 1.03-1.10: 95% CI). In the multivariate analysis, hospitalization duration of more than five days (RR=4.89, 2.29-10.40: 95% CI, P<0.001) and immobility (RR=2.49, 1.29-6.29: 95% CI, P=0.01) were found to be significantly associated with an increased risk of pressure ulcers.
Conclusion: The incidence rate of pressure ulcers observed in the present study was relatively low, measuring below 5%. Notably, prolonged hospitalization duration and immobility were identified as the most important risk factors contributing to the development of pressure ulcers among children and infants. Moreover, the utilization of specific medical devices, especially angiocaths and NCPAP masks, as well as the presence of respiratory diseases emerged as additional significant factors associated with the occurrence of pressure ulcers.
