Shulman R J, Phillips S, Laine L, Gardner P, Nichols V, Reed T, Hawkins E
Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, Houston 77030.
JPEN J Parenter Enteral Nutr. 1993 Mar-Apr;17(2):177-9. doi: 10.1177/0148607193017002177.
To determine how much blood must be discarded before one can obtain a reliable central venous catheter blood culture, we prospectively cultured the blood (from 96 patients) that is ordinarily discarded before obtaining blood for such a culture. We then compared the prospective culture results with those of the actual blood culture. Three sequentially drawn aliquots of blood were aspirated from the central venous catheter and cultured. The culture results of the second aliquot were comparable to those of the third (the portion usually cultured) in overall sensitivity (94.4%), specificity (94.9%), and positive predictive value (80.9%). Thus, the amount of blood that must be discarded (infants: 0.3 mL; children: 1.0 mL) before one can obtain an accurate central venous catheter culture is less than was previously thought.
为确定在获取可靠的中心静脉导管血培养前必须弃去多少血液，我们对通常在获取此类血培养样本前被弃去的血液（来自96例患者）进行了前瞻性培养。然后我们将前瞻性培养结果与实际血培养结果进行比较。从中心静脉导管中依次抽取三份等分血液进行培养。第二份等分血液的培养结果在总体敏感性（94.4%）、特异性（94.9%）和阳性预测值（80.9%）方面与第三份（通常进行培养的部分）相当。因此，在获取准确的中心静脉导管培养结果前必须弃去的血液量（婴儿：0.3 mL；儿童：1.0 mL）比之前认为的要少。
