title: Retrospective data about the catheter-related complications and management in massive bus burn casualties.
abstract: OBJECTIVE
  This is a single-center, descriptive report of the management and complications of venous catheter use in 19 severely burned passengers from a bus fire that occurred on July 5, 2014, in Hangzhou.
  
  
  METHODS
  We recorded the parameters of the catheters insertion and indwelling. Sampling of each removed catheter was conducted to monitor for catheter-related infections. Bedside ultrasound screening was performed for recording central venous catheter (CVC)-related complications.
  
  
  RESULTS
  Of the 174 venous accesses placed, 108 were CVCs. 27 (25.0%) catheter tip cultures (CTC) were positive; 12 (11.1%) were catheter-related blood stream infections (CRBSI). Acinetobacter baumannii was the most prominent bacterial infection for both CTC- (55.56%) and CRBSI- (75.00%) positive catheters. CTC- and CRBSI-positive rates were higher during the emergency stage, and both dropped rapidly after reform measures (chi-square test, p = 0.003), and all were negative after the no.8 catheters. Accumulative regression results indicated that total body surface area burned (TBSA), number of catheters, days of indwelling, and bloodstream infections were independently associated with CTC results, while gender and number of catheters were independently associated with CRBSI results. 1 femur vein thrombosis was detected and cured.
  
  
  CONCLUSIONS
  Bedside ultrasound and professional IV team for CVC management are pivotal for massive burn victims. Their intervention helps control CVC-related infections and other complications. A. baumannii was the most frequent bacterial infection found in both CTC- and CRBSI-positive catheters. Several most important factors associated with catheter-related infections were concluded. This information alerts us to watch for patients with such warning factors.
authors.affiliation: Assisted Reproduction Unit, Department of Obstetrics and Gynecology, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou - PR China.
authors.forename: Hongfei
authors.initials: H
authors.lastname: Jiang
authors.affiliation: Department of Burns and Wound Center, Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou - PR China.
authors.forename: Hang
authors.initials: H
authors.lastname: Hu
authors.affiliation: Department of Burns and Wound Center, Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou - PR China.
authors.forename: Haitao
authors.initials: H
authors.lastname: Ren
authors.affiliation: Department of Burns and Wound Center, Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou - PR China.
authors.forename: Chunmao
authors.initials: C
authors.lastname: Han
authors.affiliation: Department of Burns and Wound Center, Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou - PR China.
authors.forename: Xingang
authors.initials: X
authors.lastname: Wang
authors.affiliation: Department of Burns and Wound Center, Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou - PR China.
authors.forename: Chuangang
authors.initials: C
authors.lastname: You
authors.affiliation: Professional Intravenous Team, Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou - PR China.
authors.forename: Ruiyi
authors.initials: R
authors.lastname: Zhao
mesh_terms: D000151:Acinetobacter Infections / Q000175:diagnosis / Q000382:microbiology / Q000628:therapy*; D040981:Acinetobacter baumannii / Q000302:isolation & purification*; D000328:Adult; D002056:Burns / Q000175:diagnosis / Q000628:therapy*; D055499:Catheter-Related Infections / Q000175:diagnosis / Q000382:microbiology / Q000628:therapy*; D002405:Catheterization, Central Venous / Q000009:adverse effects / Q000295:instrumentation*; D002408:Catheters, Indwelling; D062905:Central Venous Catheters; D002681:China; D005260:Female; D005390:Fires; D006801:Humans; D008297:Male; D054527:Mass Casualty Incidents; D018986:Motor Vehicles; D010348:Patient Care Team; D019095:Point-of-Care Systems; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D023481:Terrorism; D013997:Time Factors; D018084:Ultrasonography, Interventional