Mesiano Eni Rosa Aires Borba, Merchán-Hamann Edgar
Health Sciences University of Brasília, Health Sciences School, Collective Health Department, Brazil.
Rev Lat Am Enfermagem. 2007 May-Jun;15(3):453-9. doi: 10.1590/s0104-11692007000300014.
Central Venous Catheters (CVC), widely used in Intensive Care Units (ICU) are important sources of bloodstream infections (BSI). This prospective cohort epidemiological analytical study, aimed to infer the incidence of BSI, the risk factors associated and evaluate the care actions related to the use of these catheters in seven ICU in the Federal District--Brasília, Brazil. From the 630 patients using CVC, 6.4% developed BSI (1.5% directly related to the catheter and 4.9% clinic BSI). The hospitalization term was 3.5 times greater among these patients. Different modalities of catheter insertion and antiseptic substances use were observed. Time of CVC permanence was significantly associated to infection incidence (p<1x10(-8)) as well as the right subclavian access and double-lumen catheters. Patients with neurological disorders and those submitted to tracheotomy were the most affected. We suggest the organization of a "catheter group" aiming to standardize procedures related to the use of catheters in order to reduce the hospitalization term and hospital costs.
中心静脉导管（CVC）在重症监护病房（ICU）中广泛使用，是血流感染（BSI）的重要来源。这项前瞻性队列流行病学分析研究旨在推断巴西巴西利亚联邦区七家ICU中BSI的发生率、相关危险因素，并评估与使用这些导管相关的护理措施。在630例使用CVC的患者中，6.4%发生了BSI（1.5%与导管直接相关，4.9%为临床BSI）。这些患者的住院时间延长了3.5倍。观察到了不同的导管插入方式和防腐剂使用情况。CVC留置时间与感染发生率显著相关（p<1x10(-8)），右锁骨下静脉置管和双腔导管也与之相关。神经系统疾病患者和接受气管切开术的患者受影响最大。我们建议组建一个“导管小组”，旨在规范与导管使用相关的程序，以缩短住院时间并降低医院成本。
