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Abstract: Introduction Central venous access is a necessity for pediatric patients with intestinal failure to provide essential nutrition for growth and development. Our study focused on complications of central venous access in these pediatric patients, mainly on central line associated bloodstream infections (CLABSIs). These infections significantly impact the overall health of the patient, contributing to increased morbidity and prolonged hospital stays. Ultimately frequent CLABSIs result in loss of vascular access sites, compromising the ability of the patient to receive TPN and necessitating an intestinal transplant for survival.3 The goal of this study is to identify factors potentially associated with central line infections, with the goal of optimizing CVC placement and usage to decrease infection rates and retain vascular access in pediatric patients with intestinal failure. Methods This study was a retrospective review of the medical record of patients with short gut syndrome in the intestinal failure multidisciplinary program at Hasbro Children’s Hospital from 2015 to present. Data was collected into a REDCAP database, investigating the frequency of bloodstream infections per catheter days. Variables recorded included information regarding line placement, removal, and infection, as well as frequency and cause of ED visits over the course of the study period. The unit of analysis was of 119 central line infection events, to understand which enteral feed characteristics were more or less likely to be infected. Cluster analysis methodology was used, grouping patients based on the Mahalanobis distance. Clustering data included information about how long lines had been in place, as well as the context of placement. Results We concluded on a three cluster solution, presented in Table 1. The first two clusters represented patients that had had relatively fewer line placements, and as such tended to be younger at the time of infection. What distinguishes cluster 1 and cluster 2 was that patients who were in-patient at time of infection occurrence tended to have more infections. The third cluster seemed to represent infections occurring after more line placements had occurred, and with that older patient ages. These lines had similar numbers of infections, however the small sample for this size makes it less precise of an estimate. Conclusion Decreasing infection rates in pediatric patients with intestinal failure is critical in maintaining central venous access, a vital aspect of their disease management. Our results further stress the importance of maintaining vascular access and reducing associated morbidity to preserve their integrity and decrease infections of central lines.
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