Limits...
Pulsative flushing as a strategy to prevent bacterial colonization of vascular access devices.

Ferroni A, Gaudin F, Guiffant G, Flaud P, Durussel JJ, Descamps P, Berche P, Nassif X, Merckx J - Med Devices (Auckl) (2014)

Bottom Line: Central venous device infections are associated with increased physical and psychological morbidity, mortality, length of stay, and costs.Each catheter was cultivated.Unflushed catheters were 20.71 and 6.42 times more polluted than catheters flushed with the pulsative method or the continuous method, respectively.

View Article: PubMed Central - PubMed

Affiliation: Assistance Publique-Hôpitaux de Paris, Laboratory of Microbiology, University Teaching Hospital Necker-Enfants Malades, Paris, France.

ABSTRACT
Central venous device infections are associated with increased physical and psychological morbidity, mortality, length of stay, and costs. The aim of this study was to prove the efficacy of pulsatile flushing to prevent the bacterial colonization of vascular access devices. One hundred and forty four tests using 576 polyurethane short venous access catheters were performed. Four catheters per test were polluted with a fibronectin-serum albumin solution. Three were filled with a Staphylococcus aureus broth; one served as negative control. One contaminated catheter was not flushed (positive control), and two were flushed (10 mL.sec(-1)) with normal saline solution, either by ten successive boluses of 1 mL each or by one bolus of 10 mL. Each catheter was cultivated. The S. aureus quantity observed after continuous flushing was significantly higher than that observed after pulsative flushing (P<0.001). Unflushed catheters were 20.71 and 6.42 times more polluted than catheters flushed with the pulsative method or the continuous method, respectively. Pulsative flushing was at least twice as effective as continuous flushing in reducing the S. aureus count. Pulsative flushing is more effective than continuous flushing in reducing the endoluminal contamination. Pulsative flushing is a simple, effective, and inexpensive technique to reduce catheter bacterial colonization.

No MeSH data available.


Related in: MedlinePlus

Histogram of contamination per flushing treatment.Abbreviation: CFU, colony forming units.
© Copyright Policy
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4230174&req=5

f2-mder-7-379: Histogram of contamination per flushing treatment.Abbreviation: CFU, colony forming units.

Mentions: During the study, 576 catheters were used. The dispersion of the contamination among the four different catheters is shown in Figure 2. Regarding the 144 tests performed, the overall comparison of the continuous and pulsative flushing counts shows that the counts observed after continuous flushing are significantly higher than those observed after pulsative flushing (P<0.001). Ten successive boluses of 1 mL are significantly more efficient than a single bolus of 10 mL. A summary of the catheter contamination results is provided in Table 1. The overall median (continuous flushing)/median (pulsative flushing) rate is 3.26 and its bootstrapped 95% confidence interval is 2.24–4.61. This means that pulsative flushing is at least twice as effective as continuous flushing in reducing the number of CFU/mL.


Pulsative flushing as a strategy to prevent bacterial colonization of vascular access devices.

Ferroni A, Gaudin F, Guiffant G, Flaud P, Durussel JJ, Descamps P, Berche P, Nassif X, Merckx J - Med Devices (Auckl) (2014)

Histogram of contamination per flushing treatment.Abbreviation: CFU, colony forming units.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4230174&req=5

f2-mder-7-379: Histogram of contamination per flushing treatment.Abbreviation: CFU, colony forming units.
Mentions: During the study, 576 catheters were used. The dispersion of the contamination among the four different catheters is shown in Figure 2. Regarding the 144 tests performed, the overall comparison of the continuous and pulsative flushing counts shows that the counts observed after continuous flushing are significantly higher than those observed after pulsative flushing (P<0.001). Ten successive boluses of 1 mL are significantly more efficient than a single bolus of 10 mL. A summary of the catheter contamination results is provided in Table 1. The overall median (continuous flushing)/median (pulsative flushing) rate is 3.26 and its bootstrapped 95% confidence interval is 2.24–4.61. This means that pulsative flushing is at least twice as effective as continuous flushing in reducing the number of CFU/mL.

Bottom Line: Central venous device infections are associated with increased physical and psychological morbidity, mortality, length of stay, and costs.Each catheter was cultivated.Unflushed catheters were 20.71 and 6.42 times more polluted than catheters flushed with the pulsative method or the continuous method, respectively.

View Article: PubMed Central - PubMed

Affiliation: Assistance Publique-Hôpitaux de Paris, Laboratory of Microbiology, University Teaching Hospital Necker-Enfants Malades, Paris, France.

ABSTRACT
Central venous device infections are associated with increased physical and psychological morbidity, mortality, length of stay, and costs. The aim of this study was to prove the efficacy of pulsatile flushing to prevent the bacterial colonization of vascular access devices. One hundred and forty four tests using 576 polyurethane short venous access catheters were performed. Four catheters per test were polluted with a fibronectin-serum albumin solution. Three were filled with a Staphylococcus aureus broth; one served as negative control. One contaminated catheter was not flushed (positive control), and two were flushed (10 mL.sec(-1)) with normal saline solution, either by ten successive boluses of 1 mL each or by one bolus of 10 mL. Each catheter was cultivated. The S. aureus quantity observed after continuous flushing was significantly higher than that observed after pulsative flushing (P<0.001). Unflushed catheters were 20.71 and 6.42 times more polluted than catheters flushed with the pulsative method or the continuous method, respectively. Pulsative flushing was at least twice as effective as continuous flushing in reducing the S. aureus count. Pulsative flushing is more effective than continuous flushing in reducing the endoluminal contamination. Pulsative flushing is a simple, effective, and inexpensive technique to reduce catheter bacterial colonization.

No MeSH data available.


Related in: MedlinePlus