Referral Center for Pediatric Gastroenterology and Nutrition, Zagreb Children's Hospital, Sisters of Mercy University Hospital Center, Zagreb, Croatia.
Clin Nutr. 2012 Oct;31(5):672-5. doi: 10.1016/j.clnu.2012.02.006. Epub 2012 Mar 7.
BACKGROUND & AIMS: The aim was to assess the rate of central venous catheter (CVC) related sepsis in patients on parenteral nutrition (PN) at our hospital center during a period of 21 years.
Data on all children hospitalized at our tertiary hospital center during the 1989-2010 period, who received PN for more than 4 weeks (n = 62) were retrospectively analyzed.
The mean age at the time of introducing PN was 2.9 years (range 6 days-17.4 years), male/female ratio 26/36. Out of these 62 patients, nine (14.5%) patients continued home PN (HPN) after discharge from the hospital. Altogether 86 CVCs were used (mean 1.39 per patient) and total CVC time was 21,459 days, which makes 243.9 days per CVC. During the study period, there were 36 CVC related sepsis episodes (1.7/1000 days of PN). Total number of septic episodes was significantly lower in HPN compared to hospital PN (0.94/1000 vs. 2.75/1000 days of PN; P < 0.001). Septic episodes led to removal of 11 (12.8%) catheters. Two patients died due to CVC related septic shock (0.93 deaths/10,000 days of PN), one in HPN patient (0.79 per 10,000 days of HPN).
The rate of CVC related sepsis in our PN cohort was exceptionally low in both hospital and home setting.
本研究旨在评估我院中心在 21 年间接受肠外营养(PN)的患者中心静脉导管(CVC)相关感染的发生率。
回顾性分析了 1989 年至 2010 年期间在我院接受 PN 治疗超过 4 周的所有住院患儿(n=62)的数据。
开始 PN 时的平均年龄为 2.9 岁(范围为 6 天至 17.4 岁),男女比例为 26/36。这些 62 例患者中有 9 例(14.5%)在出院后继续接受家庭 PN(HPN)。共使用了 86 根 CVC(平均每例患者 1.39 根),总 CVC 时间为 21459 天,每根 CVC 时间为 243.9 天。在研究期间,发生了 36 例与 CVC 相关的败血症发作(1.7/1000 天 PN)。HPN 组的感染性休克总发生率明显低于医院 PN 组(0.94/1000 与 2.75/1000 天 PN;P<0.001)。感染性休克导致 11 根导管(12.8%)被移除。两名患者因 CVC 相关感染性休克死亡(0.93 例/10000 天 PN),其中 1 例 HPN 患者(0.79 例/10000 天 HPN)。
我们的 PN 队列中,无论是在医院还是家庭环境中,CVC 相关感染的发生率都非常低。