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Severe allergic reactions identified with peripherally inserted central catheters

October 08, 2019

NEW YORK (October 8, 2019) -- Peripherally inserted central catheters (PICCs) that use a magnetized tip to guide insertion were associated with serious allergic reactions in patients, according to a study published today in Infection Control & Hospital Epidemiology, the journal for the Society for Healthcare Epidemiology of America. Severe adverse reactions occurred in patients within minutes of PICC insertion.

PICCs are long IV lines inserted through a small vein in the upper arm and into the chest to administer antibiotics, other medications, or nutrition over a long period of time. PICC lines are an alternative to central venous catheters, which require more training for insertion and are associated with more serious complications and infections.

"Our findings emphasize the need to recognize and carefully evaluate adverse reactions following PICC insertion and not to discount them as fainting episodes," said John Conly, MD, a professor of medicine at University of Calgary and Alberta Health Services, Canada, and lead author of the study. Conly said because the study is observational, it cannot be used to determine the cause of the reactions.

After reports of serious adverse events following PICC insertions, including hypersensitivity and anaphylaxis type reactions, researchers from Alberta Health Services and the University of Calgary began a four-year investigation comparing adverse events at two hospitals that used two kinds of PICCs that employed the magnetized Sherlock Tip Locating System (TLS) with two hospitals that used PICC systems that do not employ the magnetized insertion system. Standardized definitions were applied in studying the reactions since the symptoms and signs of hypersensitivity and anaphylaxis type reactions can be mimicked by many other conditions.

Investigators identified 37 anaphylactic and anaphylactoid reactions among 8,257 insertions at two centers using PICC line systems that utilized the TLS while centers inserting similar products without the magnetized tip location system did not report any such reactions with 8,380 insertions.

More than half of the reactions were in patients with previously documented drug and environmental allergies, and a third had multiple allergies; and anaphylactic/anaphylactoid reactions occurred at higher rates among patients with cystic fibrosis, with 10-16 percent of cystic fibrosis patients having reactions compared to 0.5 percent of the general population.
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Christina S. Thornton, Jody Dumanski, Cherylanne Margherit, Sandra Vaz-Gonsalves, Sheryl McDiarmid, Michael D. Parkins, and John M. Conly. "Anaphylaxis and anaphylactoid reactions associated with the insertion of peripherally inserted central catheters: A multi-year comparative retrospective cohort study." Web (October 8, 2019)

About ICHE

Published through a partnership between the Society for Healthcare Epidemiology of America and Cambridge University Press, Infection Control & Hospital Epidemiology provides original, peer reviewed scientific articles for anyone involved with an infection control or epidemiology program in a hospital or healthcare facility. ICHE is ranked 41st out of 89 Infectious Diseases Journals in the latest Web of Knowledge Journal Citation Reports from Thomson Reuters.

The Society for Healthcare Epidemiology of America (SHEA) is a professional society representing more than 2,000 physicians and other healthcare professionals around the world who possess expertise and passion for healthcare epidemiology, infection prevention, and antimicrobial stewardship. The society's work improves public health by establishing infection-prevention measures and supporting antibiotic stewardship among healthcare providers, hospitals, and health systems. This is accomplished by leading research studies, translating research into clinical practice, developing evidence-based policies, optimizing antibiotic stewardship, and advancing the field of healthcare epidemiology. SHEA and its members strive to improve patient outcomes and create a safer, healthier future for all. Visit SHEA online at http://www.shea-online.org, http://www.facebook.com/SHEApreventingHAIs and @SHEA_Epi.

About Cambridge University Press

Cambridge University Press is part of the University of Cambridge. It furthers the University's mission by disseminating knowledge in the pursuit of education, learning and research at the highest international levels of excellence. Its extensive peer-reviewed publishing lists comprise 45,000 titles covering academic research, professional development, over 400 research journals, school-level education, English language teaching and bible publishing. Playing a leading role in today's international marketplace, Cambridge University Press has over 50 offices around the globe, and it distributes its products to nearly every country in the world. For further information about Cambridge University Press, visit Cambridge.org.

Society for Healthcare Epidemiology of America

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