Storey Susan, Brown Jamie, Foley Angela, Newkirk Erica, Powers Jan, Barger Julie, Paige Karen
Indiana University School of Nursing, Indianapolis, IN.
Vincent Hospital, Indianapolis, IN.
Am J Infect Control. 2016 Jun 1;44(6):636-41. doi: 10.1016/j.ajic.2015.11.017.
Central line-associated bloodstream infections (CLABSIs) are a common life-threatening risk factor associated with central venous catheters (CVCs). Research has demonstrated benefit in reducing CLABSIs when CVCs coated with antimicrobials are inserted. The impact of chlorhexidine (CHG)-impregnated versus non-CHG peripherally inserted central catheters (PICCs) on risk of CLABSI is unknown. Venous thromboembolism (VTE) is also a complication associated with CVCs. This study compares the impact of both PICC lines on these outcomes.
Patients in 3 high-risk units were randomly assigned to receive either a CHG-impregnated or non-CHG PICC line. Laboratory data were collected and reviewed daily on all study patients. The PICC dressing site was assessed daily. Medical record documentation was reviewed to determine presence of CLABSI or VTE.
There were 167 patients who completed the study. Three patients developed CLABSI (2 in the CHG group, and 1 in the non-CHG group), and 3 patients developed VTE (2 in the non-CHG group, and 1 in the CHG group). No significant relationship was noted between the type of PICC line on development of a CLABSI (P = .61) or VTE (P > .99). A significant difference was noted in moderate bleeding (P ≤ .001) requiring thrombogenic dressing in the patients who had the CHG PICC line.
No differences were noted in the development of CLABSI and VTE between the CHG and non-CHG groups.
中心静脉导管相关血流感染（CLABSI）是与中心静脉导管（CVC）相关的常见的危及生命的风险因素。研究表明，插入涂有抗菌剂的CVC时，在降低CLABSI方面具有益处。含氯己定（CHG）的外周静脉中心导管（PICC）与不含CHG的PICC对CLABSI风险的影响尚不清楚。静脉血栓栓塞（VTE）也是与CVC相关的一种并发症。本研究比较了两种PICC导管对这些结局的影响。
3个高危科室的患者被随机分配接受含CHG的PICC导管或不含CHG的PICC导管。每天收集并审查所有研究患者的实验室数据。每天评估PICC敷料部位。审查病历记录以确定是否存在CLABSI或VTE。
有167例患者完成了研究。3例患者发生了CLABSI（CHG组2例，非CHG组1例），3例患者发生了VTE（非CHG组2例，CHG组1例）。未发现PICC导管类型与CLABSI（P = 0.61）或VTE（P > 0.99）发生之间存在显著关系。在使用含CHG的PICC导管的患者中，在需要使用促凝血敷料的中度出血方面存在显著差异（P≤0.001）。
CHG组和非CHG组在CLABSI和VTE的发生方面未发现差异。
