Microbiologic risk of invasive hemodynamic monitoring in patients undergoing open-heart operations.

The microbiologic risk of invasive hemodynamic monitoring was studied prospectively in 574 patients undergoing open-heart surgery under cover of cephalothin prophylaxis. Of a total of 2277 catheters inserted in these patients, 1.5% yielded positive cultures. The rate of positive cultures was not significantly different between percutaneous and surgically placed catheters (1.7% vs. 0.8%, respectively). Specifically, the incidence of positive catheter tips for intravenous, central venous, arterial, and pulmonary artery catheters was 1.1%, 3.9%, 1.5%, and 2.1%, respectively; while the corresponding rates for surgically inserted right atrial and left atrial catheters were 0.8% and 0, respectively. Pulmonary artery catheters had a significantly (p less than .01) higher incidence of positive catheter tips after 72 h in situ. However, there was no relationship between the in situ time and the incidence of positive tips for arterial and intravenous catheters. Although the rate of positive catheter tip cultures was low, it affected 4.9% of the patients. Nevertheless, no patient developed catheter-related septicemia or endocarditis, and the data generally supported the microbiologic safety of invasive hemodynamic monitoring in patients undergoing open-heart surgery.