The unnecessary application of central venous catheterization in surgical patients
Abstract Background and objectives Perioperative physicians occasionally encounter situations where central venous catheters placed preoperatively turn out to be unnecessary. The purpose of this retrospective study is to identify the unnecessary application of central venous catheter placement and...
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| Format: | Article |
| Language: | English |
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Sociedade Brasileira de Anestesiologia
2018-08-01
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| Series: | Revista Brasileira de Anestesiologia |
| Subjects: | |
| Online Access: | http://www.scielo.br/pdf/rba/v68n4/pt_0034-7094-rba-68-04-0336.pdf |
| _version_ | 1818753305743982592 |
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| author | Keiko Uemura Satoki Inoue Masahiko Kawaguchi |
| author_facet | Keiko Uemura Satoki Inoue Masahiko Kawaguchi |
| author_sort | Keiko Uemura |
| collection | DOAJ |
| description | Abstract Background and objectives Perioperative physicians occasionally encounter situations where central venous catheters placed preoperatively turn out to be unnecessary. The purpose of this retrospective study is to identify the unnecessary application of central venous catheter placement and determine the factors associated with the unnecessary application of central venous catheter placement. Methods Using data from institutional perioperative central venous catheter surveillance, we analysed data from 1,141 patients who underwent central venous catheter placement. We reviewed the central venous catheter registry and medical charts and allocated registered patients into those with the proper or with unnecessary application of central venous catheter according to standard indications. Multivariate analysis was used to identify factors associated with the unnecessary application of central venous catheter placement. Results In 107 patients, representing 9.38% of the overall population, we identified the unnecessary application of central venous catheter placement. Multivariate analysis identified emergencies at night or on holidays (odds ratio [OR] 2.109, 95% confidence interval [95% CI] 1.021-4.359), low surgical risk (OR = 1.729, 95% CI 1.038-2.881), short duration of anesthesia (OR = 0.961/10 min increase, 95% CI 0.945-0.979), and postoperative care outside of the intensive care unit (OR = 2.197, 95% CI 1.402-3.441) all to be independently associated with the unnecessary application of catheterization. Complications related to central venous catheter placement when the procedure consequently turned out to be unnecessary were frequently observed (9/107) compared with when the procedure was necessary (40/1034) (p = 0.032, OR = 2.282, 95% CI 1.076-4.842). However, the subsequent multivariate logistic model did not hold this significant difference (p = 0.0536, OR = 2.115, 95% CI 0.988-4.526). Conclusions More careful consideration for the application of central venous catheter is required in cases of emergency surgery at night or on holidays, during low risk surgery, with a short duration of anesthesia, or in cases that do not require postoperative intensive care. |
| first_indexed | 2024-12-18T05:05:15Z |
| format | Article |
| id | doaj.art-3497a6c9588a42988353269c17a21302 |
| institution | Directory Open Access Journal |
| issn | 1806-907X |
| language | English |
| last_indexed | 2024-12-18T05:05:15Z |
| publishDate | 2018-08-01 |
| publisher | Sociedade Brasileira de Anestesiologia |
| record_format | Article |
| series | Revista Brasileira de Anestesiologia |
| spelling | doaj.art-3497a6c9588a42988353269c17a213022022-12-21T21:20:02ZengSociedade Brasileira de AnestesiologiaRevista Brasileira de Anestesiologia1806-907X2018-08-0168433634310.1016/j.bjane.2018.01.010The unnecessary application of central venous catheterization in surgical patientsKeiko UemuraSatoki InoueMasahiko KawaguchiAbstract Background and objectives Perioperative physicians occasionally encounter situations where central venous catheters placed preoperatively turn out to be unnecessary. The purpose of this retrospective study is to identify the unnecessary application of central venous catheter placement and determine the factors associated with the unnecessary application of central venous catheter placement. Methods Using data from institutional perioperative central venous catheter surveillance, we analysed data from 1,141 patients who underwent central venous catheter placement. We reviewed the central venous catheter registry and medical charts and allocated registered patients into those with the proper or with unnecessary application of central venous catheter according to standard indications. Multivariate analysis was used to identify factors associated with the unnecessary application of central venous catheter placement. Results In 107 patients, representing 9.38% of the overall population, we identified the unnecessary application of central venous catheter placement. Multivariate analysis identified emergencies at night or on holidays (odds ratio [OR] 2.109, 95% confidence interval [95% CI] 1.021-4.359), low surgical risk (OR = 1.729, 95% CI 1.038-2.881), short duration of anesthesia (OR = 0.961/10 min increase, 95% CI 0.945-0.979), and postoperative care outside of the intensive care unit (OR = 2.197, 95% CI 1.402-3.441) all to be independently associated with the unnecessary application of catheterization. Complications related to central venous catheter placement when the procedure consequently turned out to be unnecessary were frequently observed (9/107) compared with when the procedure was necessary (40/1034) (p = 0.032, OR = 2.282, 95% CI 1.076-4.842). However, the subsequent multivariate logistic model did not hold this significant difference (p = 0.0536, OR = 2.115, 95% CI 0.988-4.526). Conclusions More careful consideration for the application of central venous catheter is required in cases of emergency surgery at night or on holidays, during low risk surgery, with a short duration of anesthesia, or in cases that do not require postoperative intensive care.http://www.scielo.br/pdf/rba/v68n4/pt_0034-7094-rba-68-04-0336.pdfCentral venous catheterCatheter placementThe unnecessary application of catheter |
| spellingShingle | Keiko Uemura Satoki Inoue Masahiko Kawaguchi The unnecessary application of central venous catheterization in surgical patients Revista Brasileira de Anestesiologia Central venous catheter Catheter placement The unnecessary application of catheter |
| title | The unnecessary application of central venous catheterization in surgical patients |
| title_full | The unnecessary application of central venous catheterization in surgical patients |
| title_fullStr | The unnecessary application of central venous catheterization in surgical patients |
| title_full_unstemmed | The unnecessary application of central venous catheterization in surgical patients |
| title_short | The unnecessary application of central venous catheterization in surgical patients |
| title_sort | unnecessary application of central venous catheterization in surgical patients |
| topic | Central venous catheter Catheter placement The unnecessary application of catheter |
| url | http://www.scielo.br/pdf/rba/v68n4/pt_0034-7094-rba-68-04-0336.pdf |
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