[经中心静脉导管采集血培养的评估]
[An evaluation of blood cultures obtained via a central venous catheter].
作者信息
Alvarez Lerma F, Baro Tomás T, Marrugat J, Molina Latorre R, Vázquez Sánchez A, Solsona Durán J F
机构信息
Servicio de Medicina Intensiva, Hospital Universitari del Mar, Barcelona.
出版信息
Med Clin (Barc). 1994 Jul 9;103(6):205-8.
BACKGROUND
The aim of this study was to determine the use of blood samples obtained through central venous catheters (CVC) in the diagnosis of bacteremias in patients admitted to an intensive care unit (ICU).
METHODS
A prospective randomized study was carried out in which 125 blood samples obtained by CVC were compared with 125 samples simultaneously obtained by venipuncture.
RESULTS
In 105 sample pairs (84%) the results of both samples were in agreement (Kappa index 0.61). The sensitivity of the technique in the diagnosis of bacteremia was 76.5%, specificity 86.8% positive predictive value 68.4% and negative predictive value 90.8%. No differences were found in the efficacy of the technique carried out by venous punction or that of the samples obtained through catheters inserted in subclavian, femoral and antecubital veins (p = 0.99).
CONCLUSIONS
Blood cultures obtained through central venous catheters constitute a technical alternative for the diagnosis of bacteremia in cases in which venipuncture is difficult or of doubtful asepsis.
背景
本研究的目的是确定通过中心静脉导管（CVC）采集的血样在重症监护病房（ICU）住院患者菌血症诊断中的应用。
方法
进行了一项前瞻性随机研究，将通过CVC采集的125份血样与同时通过静脉穿刺采集的125份血样进行比较。
结果
在105对样本（84%）中，两份样本的结果一致（卡帕指数0.61）。该技术诊断菌血症的敏感性为76.5%，特异性为86.8%，阳性预测值为68.4%，阴性预测值为90.8%。静脉穿刺技术与通过锁骨下静脉、股静脉和肘前静脉插入导管采集的样本在有效性方面未发现差异（p = 0.99）。
结论
在静脉穿刺困难或无菌操作存疑的情况下，通过中心静脉导管采集血培养样本是诊断菌血症的一种技术选择。
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