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Comparison of effectiveness of two urinary drainage systems in intensive care unit: a prospective, randomized
Marc Leone1, Franck Garnier, François Antonini
1Intensive Care Unit and Trauma Center, Nord Hospital, Marseilles University Hospital System, AP-HM, Marseilles School of Medicine, 13915, Marseilles, France. marc.leone@ap-hm.fr
Objective:
In a previous non-randomized study, we demonstrated that no difference occurred in the rate of acquisition of bacteriuria between a complex closed drainage system (CCDS) and a two-chamber drainage system (TCDS) in patients in an intensive care unit (ICU). To confirm this result, we performed a randomized, prospective, and powerful study assessing the effectiveness of the CCDS and the TCDS in ICU patients.
Design:
Randomized, prospective, and controlled study.
Setting:
Medico-surgical intensive care unit (16 beds) in a teaching hospital.
Patients And Interventions:
Three hundred and eleven patients requiring an indwelling urinary catheter for longer than 48 h were assigned individuals to the TCDS group or CCDS group to compare the rate of acquisition of bacteriuria.
Measurements And Results:
Patients did not receive prophylactic antibiotics during placement management or catheter withdrawal. Urine samples were obtained weekly for the duration of catheterization and within 24 h after catheter removal, and each time symptoms of urinary infection were suspected. There was no statistical difference in the rate of bacteriuria between the two groups. Bacteriuria occurred in 8% and 8.5% of patients for TCDS and CCDS, respectively. Rates of urinary tract infection were 12.1 and 12.8 episodes per 1,000 days of catheter.
Conclusion:
This randomized study, that compares the effectiveness of a TCDS and a CCDS in ICU patients, confirms the results of our previous study. No differences were noted between the two systems (a =0.05). The higher cost of CCDS is not justified for ICU patients.