Shinozaki T, Deane R S, Mazuzan J E, Hamel A J, Hazelton D
JAMA. 1983 Jan 14;249(2):223-5.
One hundred seventeen patients had indwelling arterial illness for hemodynamic monitoring and blood sampling. The duration of catheterization varied from 25 to 439 hours, during which time no components of the system were replaced. In contrast to other reports, our study showed no instance of contamination of transducer dome fluid when the continuous flush device was located just distal to the transducer. The sampling stopcock showed bacterial growth in 16.2% of patients. In the one case in which the arterial catheter tip, stopcock, and patient's blood showed the same organism, culture of the transducer fluid was negative. Our results suggest that elimination of a static inline fluid column and proper aseptic sampling technique limit risk to the patient of transmitted bacterial infection from the fluid in the system. Routine changes of components of the system are not indicated and a substantial cost saving can be achieved.
117名患者因血流动力学监测和采血而留置动脉导管。置管时间从25小时到439小时不等,在此期间系统组件未进行更换。与其他报告不同,我们的研究表明,当连续冲洗装置位于换能器远端时,换能器圆顶内的液体没有出现污染情况。采样旋塞在16.2%的患者中显示有细菌生长。在1例动脉导管尖端、旋塞和患者血液显示为同一微生物的病例中,换能器液体培养结果为阴性。我们的结果表明,消除静态的在线液柱以及采用适当的无菌采样技术可限制系统液体将细菌感染传播给患者的风险。无需对系统组件进行常规更换,可实现大幅成本节约。