Abstract

JAEN, Roxana  and  SAPORITI, Adrián. Infección asociada a catéter: Estudio comparativo entre recambio periódico o permanencia prolongada. Arch. argent. pediatr. [online]. 2004, vol.102, n.2, pp.96-101. ISSN 0325-0075.

Introduction. The critical situation of PICU patients demands secure vascular accesses; because of this, their use have increased in the last decades. However, the use of these devices are not free of complications, mainly infectious, making the catheter-related infection one of the most common hospital-acquired infections. Objectives. To compare the systematic guidewire catheter exchange with long term duration. To recognize differences in colonization and catheterrelated sepsis rates. Population, materials and methods. A prospective comparative study, with historical control. Forty three patients admitted to PICU were prospectively included with a historical control group of the last 50 placed catheters. Recorded items were age, gender, serum albumin, site of insertion (femoral, jugular or subclavian veins, right or left), emergency or elective placement, catheter material and type of use: exclusive, minimum or multiple. Technique: 1) guide-wire exchange (GWE): periodic catheter exchange every 4 days or because of suspected infection. Catheters were considered colonized with positive cultures with Maki ≥ 15 CFU and/or Brun-Buisson ≥ 10³ CFU and were removed. 2) Long term placement (LTP): catheters were not guide-wire exchanged except for suspected infection. Catheter-related sepsis was defined as catheter colonization plus positive blood cultures to the same microrganism and signs and symptoms of sepsis. Results. Ninety five patients were studied, 53 GWE and 42 LTP. Median age was 28 and 23 months respectively (range 1 month to 18 years). No other significant data were found except when colonization and catheter-related infection were compared. Conclusion. Long term catheter placement without guide-wire exchange reduced colonization in 50% (p= 0.09 not significant) and reduced catheter-related infection in 700% (p= 0,035), with extended use time on 5.8 days reducing both costs and morbidity.

Keywords : Catheter-related infection; Long term catheter placement; Guidewire catheter exchange.

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