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含牛磺罗定溶液减少心脏植入式电子设备感染-来自欧洲 TauroPace™登记处的早期报告。

Taurolidine-containing solution for reducing cardiac implantable electronic device infection-early report from the European TauroPace™ registry.

机构信息

Institut für Medizinische Biometrie und Statistik, Universität zu Lübeck, Ratzeburger Allee 160, 23562, Lübeck, Germany.

Institute of Life Sciences, Hochschule Bremerhaven, University of Applied Sciences Bremerhaven, An der Karlstadt 8, 27568, Bremerhaven, Germany.

出版信息

J Cardiothorac Surg. 2024 Oct 4;19(1):592. doi: 10.1186/s13019-024-03059-1.

Abstract

INTRODUCTION

Infection is a significant complication of cardiac implantable electronic device (CIED) therapy. The European TauroPace™ Registry investigates the safety and efficacy of TauroPace™ (TP), an antimicrobial solution containing taurolidine, designed to prevent CIED infections.

METHODS

This multicenter study included patients undergoing CIED procedures at participating centers where TP was used as a disinfectant for external hardware surfaces and an antiseptic for irrigating surgical sites. All patients eligible for CIED placement with adjunctive TP as the standard of care were included. Other aspects of CIED procedures adhered to current guidelines. Data on CIED-related infective endocarditis, CIED pocket infection, device and procedure-related complications, adverse events, and all-cause mortality were prospectively collected for 12 months. In cases of revision, the previous procedure was censored, and a new procedure was created. Binomial and Kaplan-Meier statistics were employed to analyze event rates.

RESULTS

From January 2020 to November 2022, TP was used in 822 out of 1170 CIED procedures. Among patients who completed the 3-month follow-up, no CIED pocket infections were observed, and one case of CIED-related infective endocarditis was reported. In the 12-month follow-up cohort, two additional local pocket CIED infections were observed, resulting in a total of three major CIED infections within 1 year after the CIED placement procedure. The 3-month and 12-month major CIED infection rates were 0.125% and 0.51%, respectively. During the observation a complication rate of 4.4% was reported. No adverse events related to TP were observed.

CONCLUSIONS

TP appears to be effective and safe in preventing CIED infections.

CLINICALTRIALS

gov Identifier: NCT04735666.

摘要

简介

感染是心脏植入式电子设备(CIED)治疗的一个重大并发症。欧洲 TauroPace™ 注册研究调查了 TauroPace™(TP)的安全性和有效性,TP 是一种含有替考拉宁的抗菌溶液,旨在预防 CIED 感染。

方法

这项多中心研究纳入了在参与中心接受 CIED 手术的患者,在这些中心,TP 被用作外部硬件表面的消毒剂和手术部位冲洗的防腐剂。所有符合条件的患者都接受了标准的附加 TP 作为辅助治疗。其他 CIED 手术的方面则遵循了当前的指南。在 12 个月的时间里,前瞻性地收集了与 CIED 相关的感染性心内膜炎、CIED 囊袋感染、器械和程序相关并发症、不良事件和全因死亡率的数据。在需要进行修正的情况下,之前的手术被记录为终点,然后开始新的手术。使用二项式和 Kaplan-Meier 统计来分析事件发生率。

结果

从 2020 年 1 月到 2022 年 11 月,TP 被用于 1170 例 CIED 手术中的 822 例。在完成 3 个月随访的患者中,没有观察到 CIED 囊袋感染,仅报告了 1 例与 CIED 相关的感染性心内膜炎。在 12 个月的随访队列中,又观察到 2 例局部囊袋 CIED 感染,导致在 CIED 放置手术后 1 年内共发生 3 例重大 CIED 感染。3 个月和 12 个月的主要 CIED 感染率分别为 0.125%和 0.51%。在观察期间,报告了 4.4%的并发症发生率。没有观察到与 TP 相关的不良事件。

结论

TP 似乎能有效预防 CIED 感染,且安全有效。

临床试验

gov 标识符:NCT04735666。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/25f3/11451193/e582f193e110/13019_2024_3059_Fig1_HTML.jpg

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