在外科手术期间评估与短期中央静脉导管相关的感染
Ángel Becerra-Bolaños1,2, Yurena Domínguez-Díaz3, Héctor Trujillo-Morales3
1Department of Anesthesiology, Intensive Care and Pain Medicine, Hospital Universitario de Gran Canaria Doctor Negrín, Las Palmas de Gran Canaria, 35010, Spain. angel.becerra@ulpgc.es.
中枢静脉导管 (CVC) 定居和中枢线相关的血流感染 (CLABSI) 在选择性手术患者中发生的比例很高. 导管殖民风险因素包括瘤疾病和缺血性心脏病,而不是导管持续时间.
科学领域:
- 医学微生物学 医学微生物学
- 传染性疾病 传染性疾病
- 手术重症监护手术重症监护
背景情况:
- 中枢静脉导管 (CVC) 的使用在手术中很常见,但与导管相关的感染等严重并发症有关.
- 与导管相关的感染对患者的发病率和死亡率有很大影响.
- 了解CVC相关感染的发病率和风险因素对于患者安全至关重要.
研究的目的:
- 评估CVC殖民和CLABSI在选择性外科手术中短期CVC的发生率.
- 在这个患者群体中确定与CVC殖民和CLABSI相关的风险因素.
主要方法:
- 对200名接受选择性手术的患者进行了前性观察性研究,手术期间插入了短期CVCs.
- 排除标准包括先前存在的感染,手术前的抗生素,计划的CVC持续时间>14天,年龄<18岁,以及拒绝参与.
- 数据收集包括导管持续时间,殖民率,CLABSI率,以及分析潜在的风险因素.
主要成果:
- 殖民导管的发生率为6% (8.84/1000导管日),CLABSI为3.5% (5.15/1000导管日).
- 殖民化的危险因素包括瘤疾病,缺血性心脏病和静脉导管.
- 对于CLABSI的危险因素是60岁以上的年龄和瘤疾病. 导管持续时间不是殖民化的重要风险因素.
结论:
- 观察到高发病率的CVC殖民和CLABSI,即使短期使用CVC在受控环境中.
- 导管殖民风险受患者特定因素的影响,而不仅仅是导管持续时间.
- 识别和减轻瘤疾病和患者年龄等风险因素对于预防CVC相关感染至关重要.
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