Esteves Alexandre de Oliveira, Figueiredo Vitor Lauar Pimenta de, Saes Glauco Fernandes, Zerati Antônio Eduardo, Puech-Leão Pedro, Wolosker Nelson, Luccia Nelson De
Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.
Faculdade Israelita de Ciências da Saúde Albert Einstein, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
Einstein (Sao Paulo). 2024 Dec 9;22:eAO0736. doi: 10.31744/einstein_journal/2024AO0736. eCollection 2024.
To evaluate the incidence of malfunction and colonization rates of fully implantable long-term catheters left unflushed during the COVID-19 pandemic; and to evaluate the average cost of transporting each patient to the hospital for flushing.
During the COVID-19 pandemic, patients reduced the number of hospital visits and stopped flushing their catheters periodically with saline solution. After the pandemic stabilized in 2022, patients who completed chemotherapy treatment had their long-term catheters removed. We evaluated the catheters' function and colonization rates. To evaluate the incidence of malfunctions and the colonization rate of these catheters, we tested the flow and reflux during removal surgery, before removal, and by culturing their tips. These catheters were divided into two groups: a standard group, in which the last flushing occurred before 90 days, and another group, in which the last flushing occurred after 90 days. We analyzed the correlation between the time at which these catheters were closed, the incidence of malfunction, and the colonization rate of these catheters. To avoid confusion due to the reduced sample size, a second analysis was performed between the group of catheters that did not work and those that worked, evaluating the time they were closed and the catheter tip culture. We also analyzed the financial costs for each patient from home to the hospital.
Among the 66 patients included in the study, 28 spent >90 days without catheter flushing, and 38 spent <90 days. The incidence of infection occurred in two patients with >90 days of flushing and in three patients with <90 days of flushing. Catheter malfunction occurred in 4 patients in the group with >90 days without flushing and in 5 patients with <90 days of flushing. In the secondary analysis, the group with a functioning catheter (n=52) had a mean time of 152 days, whereas for the group with a non-functioning catheter (n=9), the mean time was 229 days (p=0.51). No differences were statistically significant. No correlation was found between the colonization rate of catheter in the group with a functioning or non-functioning catheter, as the group with a functioning catheter had three cases of positive catheter tip culture and the group with a non-functioning catheter had one case of positive catheter tip culture. The average cost for each patient to travel from home to the hospital was 39.01 reais (approximately 7.50 USD).
Among the patients followed up at our hospital during the COVID-19 pandemic, no statistically significant difference was observed in the function and colonization rate of long-term catheters between those who underwent flushing at intervals of <90 days and those with intervals of >90 days.
评估在新冠疫情期间完全植入式长期导管未进行冲洗时的故障发生率和定植率；并评估将每位患者送至医院进行冲洗的平均费用。
在新冠疫情期间，患者减少了医院就诊次数，并停止定期用盐溶液冲洗导管。2022年疫情稳定后，完成化疗治疗的患者拔除了长期导管。我们评估了导管的功能和定植率。为评估这些导管的故障发生率和定植率，我们在拔除手术期间、拔除前以及通过培养导管尖端来测试流量和反流情况。这些导管分为两组：标准组，最后一次冲洗发生在90天之前；另一组，最后一次冲洗发生在90天之后。我们分析了这些导管关闭时间、故障发生率和定植率之间的相关性。为避免因样本量减少造成混淆，在无法正常使用的导管组和可正常使用的导管组之间进行了第二次分析，评估了它们的关闭时间和导管尖端培养情况。我们还分析了每位患者从家到医院的经济成本。
在纳入研究的66例患者中，28例导管冲洗间隔时间超过90天，38例少于90天。冲洗时间超过90天的2例患者和冲洗时间少于90天的3例患者发生了感染。冲洗间隔时间超过90天的组中有4例患者出现导管故障，冲洗间隔时间少于90天的组中有5例患者出现导管故障。在二次分析中，导管功能正常的组（n = 52）平均使用时间为152天，而导管功能异常的组（n = 9）平均使用时间为229天（p = 0.51）。差异无统计学意义。在功能正常或异常的导管组中，导管定植率之间未发现相关性，因为功能正常的导管组有3例导管尖端培养呈阳性，功能异常的导管组有1例导管尖端培养呈阳性。每位患者从家到医院的平均费用为39.01雷亚尔（约7.50美元）。
在我院新冠疫情期间随访的患者中，冲洗间隔时间少于90天和超过90天的患者，其长期导管的功能和定植率未观察到统计学上的显著差异。
