Stavropoulos M, Spiliotis J, Arvaniti A, Rathosis S, Kalfarentzos F
Department of Surgery, University of Patras School of Medicine, Greece.
Nutrition. 1989 Jul-Aug;5(4):241-2.
During a 1-year period, 24 of 71 patients receiving total parenteral nutrition, underwent replacement of their central venous catheter (CVC) for presumed CVC sepsis or catheter malposition with the use of a wire inducer, according to the Seldinger technique. Catheters were defined as sterile when cultures of both the catheter tip and the peripheral blood were negative, contaminated when culture of the tip was positive whereas the peripheral blood culture(s) was either sterile or positive with different bacteria than those obtained from the tip culture, and septic when cultures from the catheter tip and peripheral blood grew identical microorganisms. Among 19 catheters with suspected sepsis, six were sterile, ten contaminated and three septic. Guidewire catheter replacement was easily and safely performed, and succeeded in sterilizing all contaminated catheters but only one of three septic catheters.
在1年的时间里,71例接受全胃肠外营养的患者中有24例因疑似中心静脉导管(CVC)败血症或导管位置不当,根据Seldinger技术使用导丝诱导器更换了中心静脉导管。当导管尖端和外周血培养均为阴性时,导管被定义为无菌;当尖端培养为阳性而外周血培养无菌或与尖端培养所得细菌不同时为阳性时,导管被定义为污染;当导管尖端和外周血培养生长出相同微生物时,导管被定义为败血症。在19根疑似败血症的导管中,6根无菌,10根污染,3根败血症。导丝引导下的导管更换操作简便、安全,成功使所有污染导管无菌化,但3根败血症导管中仅1根成功。