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Anaphylaxis and anaphylactoid reactions associated with the insertion of peripherally inserted central catheters: A multiyear comparative retrospective cohort study

Part of: WILLIAM JARVIS AWARD RECIPIENTS

Published online by Cambridge University Press:  08 October 2019

Christina S. Thornton ,
Jody Dumanski ,
Cherylanne Margherit ,
Sandra Vaz-Gonsalves ,
Sheryl McDiarmid ,
Michael D. Parkins  and
John M. Conly
Christina S. Thornton
Affiliation:
Department of Medicine, University of Calgary and Alberta Health Services, Calgary, Alberta, Canada
Jody Dumanski
Affiliation:
Advanced Venous Access Service, Alberta Health Services, Calgary, Alberta, Canada
Cherylanne Margherit
Affiliation:
Advanced Venous Access Service, Alberta Health Services, Calgary, Alberta, Canada
Sandra Vaz-Gonsalves
Affiliation:
Advanced Venous Access Service, Alberta Health Services, Calgary, Alberta, Canada
Sheryl McDiarmid
Affiliation:
The Ottawa Hospital and Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
Michael D. Parkins
Affiliation:
Department of Medicine, University of Calgary and Alberta Health Services, Calgary, Alberta, Canada Department of Microbiology, Immunology and Infectious Diseases, University of Calgary, Calgary, Alberta
John M. Conly*
Affiliation:
Department of Medicine, University of Calgary and Alberta Health Services, Calgary, Alberta, Canada Department of Microbiology, Immunology and Infectious Diseases, University of Calgary, Calgary, Alberta Synder Institute for Chronic Diseases, Cumming School of Medicine, University of Calgary and Alberta Health Services, Calgary, Alberta, Canada Department of Pathology and Laboratory Medicine, University of Calgary and Alberta Health Services, Calgary, Alberta, Canada
*
Author for correspondence: John M. Conly, Email: [email protected].
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Abstract

Objective:

Peripherally inserted central catheters (PICCs) are a mainstay of nonpermanent vascular access devices. In this study, we assessed patients displaying anaphylaxis or anaphylactoid reactions to the PowerPICC SOLO and Groshong PICC (Bard Access Systems) using the Sherlock tip locating system (TLS).

Methods:

Patients from 2 tertiary-care hospitals were systematically monitored over 4 years for adverse events following the insertion of a PICC using the Sherlock TLS. Insertion data were also collected using the BioFlo PICC (Angiodynamics)from a third hospital site and from The Ottawa Hospital over 4 years as an additional comparator. Three definitions of anaphylaxis and anaphylactoid reactions were utilized, and the Cohen κ was used to assess interrater agreement. Analysis of reactions among the patient cohorts was performed using the χ2 test with Yates correction or the Fisher exact test as appropriate.

Results:

Among 8,257 insertions using the TLS PICCs, 37 potential reactions (0.45%) were recorded. Using specific definitions for anaphylaxis or anaphylactoid reactions, 54.1%–91.9% met criteria. Comparator populations using data from Calgary (n = 491) and Ottawa (n = 7,889) using the BioFlo PICC insertion found no reactions. Anaphylactic or anaphylactoid reactions were significantly associated with the PowerPICC SOLO and Groshong PICC with the TLS compared to the BioFlo PICC (P < .0001) across all definitions. The largest subset of patients experiencing adverse reactions had cystic fibrosis (CF) (n = 4, 10.8%).

Conclusion:

Our study results demonstrate significant adverse events associated with the PowerPICC SOLO and Groshong PICC using the Sherlock TLS inserted across a range of patient populations. The incidence rate of anaphylaxis or anaphylactoid reactions in the CF population at our center is significantly higher than in non-CF patients (P < .001).

Type
Original Article
Information
Infection Control & Hospital Epidemiology , Volume 40 , Issue 11 , November 2019 , pp. 1215 - 1221
Copyright
© 2019 by The Society for Healthcare Epidemiology of America. All rights reserved. 

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References

Johansson, E, Hammarskjold, F, Lundberg, D and Arnlind, MH. Advantages and disadvantages of peripherally inserted central venous catheters (PICC) compared to other central venous lines: a systematic review of the literature. Acta Oncol 2013;52:886–892.CrossRefGoogle ScholarPubMed
Sharp, R, Esterman, A, McCutcheon, H, Hearse, N, Cummings, M. The safety and efficacy of midlines compared to peripherally inserted central catheters for adult cystic fibrosis patients: a retrospective, observational study. Int J Nurs Stud 2014;51:694–702.CrossRefGoogle ScholarPubMed
Maki, DG, Kluger, DM, Crnich, CJ. The risk of bloodstream infection in adults with different intravascular devices: a systematic review of 200 published prospective studies. Mayo Clin Proc 2006;81:1159–1171.CrossRefGoogle ScholarPubMed
Ajenjo, MC, Morley, JC, Russo, AJ, et al. Peripherally inserted central venous catheter-associated bloodstream infections in hospitalized adult patients. Infect Control Hosp Epidemiol 2011;32:125–130.CrossRefGoogle ScholarPubMed
Blum, DY. Untoward events associated with use of midterm i.v. devices. J Intraven Nurs 1995;18:116–119.Google ScholarPubMed
Briars, G. Adverse reactions to elastomeric intravenous catheters in adolescents with cystic fibrosis. Lancet 1993;342:118.CrossRefGoogle ScholarPubMed
Haworth, CS, Niven, RM, Moorcroft, AJ, Phillips, A, Dodd, ME, Webb, AK. Acute anaphylaxis following midline catheterisation in a patient with cystic fibrosis. Thorax 1999;54:747.CrossRefGoogle Scholar
Seckold, T, Walker, S, Dwyer, T. A comparison of silicone and polyurethane PICC lines and postinsertion complication rates: a systematic review. J Vasc Access 2015;16:167–177.CrossRefGoogle ScholarPubMed
Vanek, VW, Kupensky, DT, Thomson, DJ. Hypersensitivity-like reactions related to insertion of aquavene-based midline and PICC catheters. J Intraven Nurs 1997;20:23–27.Google ScholarPubMed
Mermel, LA, Parenteau, S, Tow, SM. The risk of midline catheterization in hospitalized patients: a prospective study. Ann Intern Med 1995;123:841–844.CrossRefGoogle ScholarPubMed
Moorcroft, AJ, Niven, R, Quantrill, S. Midline catheterization in hospitalized patients. Ann Intern Med 1996;125:695.CrossRefGoogle ScholarPubMed
Chopra, V, Flanders, SA, Saint, S. The problem with peripherally inserted central catheters. JAMA 2012;308:1527–1528.CrossRefGoogle ScholarPubMed
Grau, D, Clarivet, B, Lotthe, A, Bommart, S, Parer, S. Complications with peripherally inserted central catheters (PICCs) used in hospitalized patients and outpatients: a prospective cohort study. Antimicrob Resist Infect Control 2017;6:18.CrossRefGoogle ScholarPubMed
McDiarmid, S, Scrivens, N, Carrier, M, et al. Outcomes in a nurse-led peripherally inserted central catheter program: a retrospective cohort study. CMAJ Open 2017;5:E535–E539.CrossRefGoogle Scholar
McDiarmid, S. The real “D” in decision making. J Can Vasc Access Assoc 2012;Winter:21–25.Google Scholar
Huang, V DI, Scarazzini, L. Pharmacovigilance review. Focalin and focalin XR. Office of Surveillance and Epidemiology: Department of Health and Human Services, Public Health Service, Good and Drug Administration. Center for Drug Evaluation and Research, 2011.Google Scholar
Lieberman, P, Nicklas, RA. The diagnosis and management of anaphylaxis practice parameter: 2010 update. J Allergy Clin Immunol 2010;126:477–480.CrossRefGoogle ScholarPubMed
Zinderman, CE, Landow, L, Wise, RP. Anaphylactoid reactions to Dextran 40 and 70: reports to the United States Food and Drug Administration, 1969 to 2004. J Vasc Surg 2006;43:1004–1009.CrossRefGoogle ScholarPubMed
McHugh, ML. Interrater reliability: the kappa statistic. Biochem Med (Zagreb) 2012;22:276–282.CrossRefGoogle ScholarPubMed
Office of Surveillance and Biometrics CfDaRH, Food and Drug Administration. Adverse medical device experience reports for Menlo Care from the Device Experience Network. 1990.Google Scholar
Parmar, JS, Nasser, S. Antibiotic allergy in cystic fibrosis. Thorax 2005;60:517–520.CrossRefGoogle ScholarPubMed
Gernez, Y, Dunn, CE, Everson, C, et al. Blood basophils from cystic fibrosis patients with allergic bronchopulmonary aspergillosis are primed and hyper-responsive to stimulation by aspergillus allergens. J Cyst Fibros 2012;11:502–510.CrossRefGoogle ScholarPubMed
Suzuki, Y, Inoue, T, Ra, C. Autoimmunity-inducing metals (Hg, Au and Ag) modulate mast cell signaling, function and survival. Curr Pharm Des 2011; 17: 3805–14.CrossRefGoogle Scholar
Hayama, K, Suzuki, Y, Inoue, T, Ochiai, T, Terui, T, Ra, C. Gold activates mast cells via calcium influx through multiple H2O2-sensitive pathways including L-type calcium channels. Free Radic Biol Med 2011;50:1417–1428.CrossRefGoogle ScholarPubMed
Suzuki, Y, Yoshimaru, T, Yamashita, K, Matsui, T, Yamaki, M, Shimizu, K. Exposure of RBL-2H3 mast cells to Ag(+) induces cell degranulation and mediator release. Biochem Biophys Res Commun 2001;283:707–714.CrossRefGoogle ScholarPubMed
Ruggeberg, JU, Gold, MS, Bayas, JM, et al. Anaphylaxis: case definition and guidelines for data collection, analysis, and presentation of immunization safety data. Vaccine 2007;25:5675–5684.CrossRefGoogle ScholarPubMed