중화상 환자에서 중심정맥 카테터 감염: 쇄골하정맥과 대퇴정맥의 비교
- 장영호; 손용훈; 김상규; 박준모; 이미영; 김진모
- Publication Year
- Bacteremia; Burn; Catheter-related infections; Catheters; Intensive care units
- Background: A central venous catheter (CVC) is usually inserted in patients with severe burns and the selection
of the CVC is often difficult due to widespread burned skin. We investigated the incidences of colonization and
catheter-related blood stream infection (CRBSI) according to the insertion site of the CVC in major burn patients.
Methods: In 63 adult massive burn patients in the intensive care unit, 93 CVCs (47 polyurethane standard CVCs
and 46 Oligon anti-mocrobial CVCs) were randomly inserted via the subclavian vein (SCV group, n = 66) or femoral
vein (FEV group, n = 27). All catheter tips removed were routinely cultured. Bacterial findings from the burn
wound and peripheral blood were also monitored in all patients.
Results: There was no significant difference in the average insertion length of the CVC (14.3 ± 6.8 days in SCV
and 13.6 ± 3.8 days in FEV) between the two groups. There were no significant differences in CVC colonization
(48.5% in SCV and 63.0% in FEV) and CRBSI (7.6% in SCV and 11.1% in FEV) between the two groups.
Logistic analysis found that the use of polyurethane standard CVC is significantly associated with increased risk of
CVC colonization (odds ratio = 2.68).
Conclusions: The placement of the CVC via the femoral vein does not increase the incidence of CVC colonization
in massive burn patients. The use of Oligon anti-microbial CVC may be helpful to reduce CVC colonization
in major burn patients.
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