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洗必泰浸渍敷料与小儿重症监护病房导管相关血流感染的预防

Chlorhexidine-Impregnated Dressings and Prevention of Catheter-Associated Bloodstream Infections in a Pediatric Intensive Care Unit.

作者信息

Düzkaya Duygu Sönmez, Sahiner Nejla Canbulat, Uysal Gülzade, Yakut Tülay, Çitak Agop

机构信息

Duygu Sönmez Düzkaya is the director of nursing services and a nurse educator, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey.

Nejla Canbulat Sahiner is an associate professor, Pediatric Nursing Department, Karamanoglu Mehmetbey University, Karaman, Turkey.

出版信息

Crit Care Nurse. 2016 Dec;36(6):e1-e7. doi: 10.4037/ccn2016561.

Abstract

BACKGROUND

Bloodstream infections related to use of catheters are associated with increased morbidity and mortality rates, prolonged hospital lengths of stay, and increased medical costs.

OBJECTIVES

To compare the effectiveness of chlorhexidine-impregnated dressings with that of standard dressings in preventing catheter-related bloodstream infections.

METHODS

A total of 100 children were randomly divided into 2 groups of 50 each: a chlorhexidine group and a standard group. Patient care was provided in accordance with prevention bundles. Patients were followed up for development of catheter-related bloodstream infections.

RESULTS

Catheter colonization occurred in 4 patients in the standard group (8%) and in 1 patient in the chlorhexidine group (2%). Catheter-related bloodstream infections occurred in 5 patients in the standard group (10%) and in 1 patient in the chlorhexidine group (2%). Although more patients in the standard group had catheter-related bloodstream infections, the difference in infection rates between the 2 groups was not significant (P = .07).

CONCLUSIONS

Use of chlorhexidine-impregnated dressings reduced rates of catheter-related bloodstream infections, contamination, colonization, and local catheter infection in a pediatric intensive care unit but was not significantly better than use of standard dressings.

摘要

背景

与导管使用相关的血流感染与发病率和死亡率增加、住院时间延长以及医疗费用增加有关。

目的

比较洗必泰浸渍敷料与标准敷料在预防导管相关血流感染方面的有效性。

方法

总共100名儿童被随机分为两组,每组50名:洗必泰组和标准组。按照预防集束措施提供患者护理。对患者进行随访以观察导管相关血流感染的发生情况。

结果

标准组有4名患者(8%)发生导管定植,洗必泰组有1名患者(2%)发生导管定植。标准组有5名患者(10%)发生导管相关血流感染,洗必泰组有1名患者(2%)发生导管相关血流感染。虽然标准组有更多患者发生导管相关血流感染,但两组之间的感染率差异不显著(P = 0.07)。

结论

在儿科重症监护病房中,使用洗必泰浸渍敷料可降低导管相关血流感染、污染、定植和局部导管感染的发生率,但并不显著优于使用标准敷料。

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