PMID- 24954426
OWN - NLM
STAT- MEDLINE
DCOM- 20150518
LR  - 20181202
IS  - 1532-8414 (Electronic)
IS  - 1071-9164 (Linking)
VI  - 20
IP  - 9
DP  - 2014 Sep
TI  - Are peripherally inserted central catheters associated with increased risk of 
      adverse events in status 1B patients awaiting transplantation on continuous 
      intravenous milrinone?
PG  - 630-7
LID - S1071-9164(14)00235-8 [pii]
LID - 10.1016/j.cardfail.2014.06.004 [doi]
AB  - BACKGROUND: Peripherally inserted central catheters (PICCs) are used to deliver 
      continuous intravenous (IV) milrinone in stage D heart failure (HF) patients 
      awaiting heart transplantation (HT). METHODS: We retrospectively analyzed PICC 
      adverse events (AEs) and associated cost in 129 status 1B patients from 2005 to 
      2012. End points were HT, left ventricular assist device (LVAD), and death. 
      Regression analysis was used to identify AE risk factors. RESULTS: Fifty-three 
      PICC AEs occurred in 35 patients (27%), consisting of 48 infections, 4 
      thromboses, and 1 bleeding event. Median duration of PICC support was 63 
      (interquartile range [IQR] 34-131) days, and median time to first PICC infection 
      was 44 (IQR 14-76) days. Among PICC infections, 9% required defibrillator removal 
      and 30% were inactivated on the HT list for a mean of 23 +/- 17 days. Rate of HT, 
      LVAD, or death was similar between groups (P > .05). Regression analysis found 
      that a double lumen PICC was associated with a shorter time to first PICC 
      infection (hazard ratio 7.59, 95% CI 1.97-29.23; P = .003). Median cost per PICC 
      infection was $10,704 (IQR $7,401-$26,083). CONCLUSIONS: PICC infections were the 
      most frequent AEs. PICCs with >1 lumen were associated with increased risk of 
      infection. PICC AEs accounted for increased intensive care unit admissions, HT 
      list inactivations, and overall cost.
CI  - Copyright (c) 2014 Elsevier Inc. All rights reserved.
FAU - Haglund, Nicholas A
AU  - Haglund NA
AD  - Division of Cardiology, Vanderbilt University Medical Center, Nashville, 
      Tennessee. Electronic address: Nicholas.a.haglund@vanderbilt.edu.
FAU - Cox, Zachary L
AU  - Cox ZL
AD  - Pharmacy Practice, Lipscomb University College of Pharmacy, Nashville, Tennessee.
FAU - Lee, Jeff T
AU  - Lee JT
AD  - Pharmacy Practice, Lipscomb University College of Pharmacy, Nashville, Tennessee.
FAU - Song, Yanna
AU  - Song Y
AD  - Department of Biostatistics, Vanderbilt University School of Medicine, Vanderbilt 
      University Medical Center, Nashville, Tennessee.
FAU - Keebler, Mary E
AU  - Keebler ME
AD  - Division of Cardiology, Vanderbilt University Medical Center, Nashville, 
      Tennessee.
FAU - DiSalvo, Thomas G
AU  - DiSalvo TG
AD  - Division of Cardiology, Vanderbilt University Medical Center, Nashville, 
      Tennessee.
FAU - Maltais, Simon
AU  - Maltais S
AD  - Cardiovascular Surgery, Vanderbilt University Medical Center, Nashville, 
      Tennessee.
FAU - Lenihan, Daniel J
AU  - Lenihan DJ
AD  - Division of Cardiology, Vanderbilt University Medical Center, Nashville, 
      Tennessee.
FAU - Wigger, Mark A
AU  - Wigger MA
AD  - Division of Cardiology, Vanderbilt University Medical Center, Nashville, 
      Tennessee.
LA  - eng
GR  - T32HL007411/HL/NHLBI NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
DEP - 20140617
PL  - United States
TA  - J Card Fail
JT  - Journal of cardiac failure
JID - 9442138
RN  - 0 (Cardiotonic Agents)
RN  - JU9YAX04C7 (Milrinone)
SB  - IM
CIN - J Card Fail. 2014 Sep;20(9):638-40. PMID: 25058009
MH  - Academic Medical Centers
MH  - Cardiotonic Agents/*therapeutic use
MH  - Catheter-Related Infections/economics/epidemiology
MH  - Catheterization, Central Venous/*adverse effects/instrumentation
MH  - Catheterization, Peripheral/*adverse effects/instrumentation
MH  - Female
MH  - Heart Failure/classification/*drug therapy
MH  - Heart Transplantation
MH  - Heart-Assist Devices
MH  - Hemorrhage/epidemiology
MH  - Humans
MH  - Infusions, Intravenous
MH  - Intensive Care Units/statistics & numerical data
MH  - Male
MH  - Middle Aged
MH  - Milrinone/*therapeutic use
MH  - Regression Analysis
MH  - Retrospective Studies
MH  - Tennessee/epidemiology
MH  - Venous Thromboembolism/epidemiology
MH  - Waiting Lists
OTO - NOTNLM
OT  - Heart failure
OT  - infection
OT  - inotrope
OT  - peripherally inserted central catheter
EDAT- 2014/06/24 06:00
MHDA- 2015/05/20 06:00
CRDT- 2014/06/24 06:00
PHST- 2014/04/16 00:00 [received]
PHST- 2014/05/22 00:00 [revised]
PHST- 2014/06/09 00:00 [accepted]
PHST- 2014/06/24 06:00 [entrez]
PHST- 2014/06/24 06:00 [pubmed]
PHST- 2015/05/20 06:00 [medline]
AID - S1071-9164(14)00235-8 [pii]
AID - 10.1016/j.cardfail.2014.06.004 [doi]
PST - ppublish
SO  - J Card Fail. 2014 Sep;20(9):630-7. doi: 10.1016/j.cardfail.2014.06.004. Epub 2014 
      Jun 17.