Kaur Davinder, Jaspal Surinder, Bajwa Sukhminderjit Singh
Principal, Gian Sagar College of Nursing, RamNagar, Patiala, Punjab, India.
Principal, Guru Nanak College of Nursing, Dahan Kaleran, SBS Nagar, Punjab, India.
Iran J Nurs Midwifery Res. 2020 Nov 7;25(6):497-501. doi: 10.4103/ijnmr.IJNMR_34_19. eCollection 2020 Nov-Dec.
Use of Central Venous Catheters (CVC) can be associated with increased incidence of Catheter-Related Bloodstream Infections (CRBSIs). The present study assessed the impact of open versus closed catheter access system of CVC on infection prevention in critically sick patients admitted in the Intensive Care Unit (ICU).
After obtaining ethical clearance and consent of relatives of the patients admitted in ICU of our institute, the present study was carried out as a randomized, prospective, double-blind trial with parallel group design (of 200 patients in each group). In study group (Group I), closed catheter access system (Luer access split septum) was used, while open access (three-way) system was used in the control group. Among clinical parameters, if any patient developed fever, his/her blood, urine, and tracheal secretions were sent for culture and sensitivity. Collected data were analyzed using descriptive and inferential statistics.
Demographic profile was similar in both the groups. Significant clinical and statistical differences were observed in blood culture values (χ = 58.30, df = 1, < 0.001) as well as Total Leukocyte Counts (TLC) on day 1, 4, and 8 (F= 80.61, < 0.001). However, no statistically significant (t= 0.90, = 0.367) difference was found in the duration of hospital stay among patients in both the groups despite significant differences in various clinical parameter.
Luer access split septum connectors along with appropriate training of the nursing personals decrease CRBSI.
使用中心静脉导管（CVC）可能会增加导管相关血流感染（CRBSI）的发生率。本研究评估了CVC的开放与封闭导管接入系统对重症监护病房（ICU）收治的危重病患者预防感染的影响。
在获得我院ICU收治患者亲属的伦理批准和同意后，本研究作为一项随机、前瞻性、双盲试验进行，采用平行组设计（每组200例患者）。研究组（第一组）使用封闭导管接入系统（鲁尔接头分隔隔膜），而对照组使用开放接入（三通）系统。在临床参数方面，如果任何患者出现发热，将采集其血液、尿液和气管分泌物进行培养和药敏试验。使用描述性和推断性统计分析收集的数据。
两组患者人口统计学特征相似。在第1天、第4天和第8天的血培养值（χ = 58.30，自由度 = 1，P < 0.001）以及总白细胞计数（TLC）方面观察到显著的临床和统计学差异（F = 80.61，P < 0.001）。然而，尽管各项临床参数存在显著差异，但两组患者的住院时间差异无统计学意义（t = 0.90，P = 0.367）。
鲁尔接头分隔隔膜连接器以及对护理人员进行适当培训可降低CRBSI。
