Intensive Care Unit Research Unit of the Hospital Universitario de Canarias, Tenerife, Spain.
Clin Microbiol Infect. 2011 Jun;17(6):870-2. doi: 10.1111/j.1469-0691.2010.03406.x. Epub 2010 Dec 3.
Guidelines for the prevention of catheter-related bloodstream infection (CRBSI) recommend subclavian rather than femoral venous access to minimize the risk of CRBSI. However, they do not address the issue of CRBSI with subclavian venous access in the presence of tracheostomy, where the incidence of CRBSI has been found to be higher than without tracheostomy. In this study, we found lower CRBSI in subclavian venous access in the presence of tracheostomy than in femoral venous access (3.9 vs. 10.1 CRBSI per 1000 catheter-days; odds ratio = 0.39; 95% confidence interval ≤0.001-0.91; p 0.03).
预防导管相关性血流感染（CRBSI）指南建议使用锁骨下而非股静脉通路，以最大程度降低 CRBSI 的风险。然而，这些指南并未涉及到存在气管切开的情况下，锁骨下静脉通路发生 CRBSI 的问题，在这种情况下，CRBSI 的发生率高于没有气管切开的情况。在这项研究中，我们发现与股静脉通路相比，在存在气管切开的情况下，锁骨下静脉通路的 CRBSI 发生率更低（每 1000 个导管日的 CRBSI 发生率分别为 3.9 比 10.1；比值比=0.39；95%置信区间≤0.001-0.91；p=0.03）。
