Lancet:缩短设备更换间隔对导管相关血流感染风险的影响

2021-04-17 MedSci原创 MedSci原创

对于需接受中央静脉接入装置或外周动脉导管介入治疗的患者,缩短设备更换时间至4天不能降低导管相关血流感染风险,现行的7日更换间隔是安全的,可有效降低成本,减少医护人员工作量

临床上,中央静脉接入装置或外周动脉导管的使用率很高,侵入性装置导致的患者导管相关血流感染(CRBSI)风险增加。统计发现,CRBSI发生率约占所有医疗干预相关血液感染的70%,平均每位患者的治疗费用高达45814美元。更换接入装置或导管可能降低患者CRBSI风险,但更换的时间间隔及成本效益尚不明确。

近日研究人员考察了与标准的7天使用时限相比,每4天更换接入装置或导管对预防CRBSI的效果及成本效益。

本次研究在10家澳大利亚医院开展,为随机,对照,非劣性研究。预期使用中心静脉导管超过24小时的成人和儿童患者参与,随机每7天或4天更换一次接入装置,研究的主要终点为CRBSI,非劣性边界为2%。

2944名患者参与研究,其中7天更换组1463人,4天更换组1481人, 2941名患者数据纳入终点分析。在中央静脉接入装置组,7日组1124例患者中有20例(1.78%)出现CRBSI,4日组1097例患者中有16例(1.46%,绝对风险差异[ARD]0.32%)。在外周动脉导管组,7日组357例患者中有1例(0.28%)出现CRBSI,4日组363例患者未出现CRBSI(ARD=0.28%)。未发生治疗相关的不良事件。

研究认为,对于需接受中央静脉接入装置或外周动脉导管介入治疗的患者,缩短设备更换时间至4天不能降低导管相关血流感染风险,现行的7日更换间隔是安全的,可有效降低成本,减少医护人员工作量。

原始出处:

Prof Claire M Rickard et al.Effect of infusion set replacement intervals on catheter-related bloodstream infections (RSVP): a randomised, controlled, equivalence (central venous access device)–non-inferiority (peripheral arterial catheter) trial.Lancet. April 17,2021.

版权声明:
本网站所有内容来源注明为“梅斯医学”或“MedSci原创”的文字、图片和音视频资料,版权均属于梅斯医学所有。非经授权,任何媒体、网站或个人不得转载,授权转载时须注明来源为“梅斯医学”。其它来源的文章系转载文章,或“梅斯号”自媒体发布的文章,仅系出于传递更多信息之目的,本站仅负责审核内容合规,其内容不代表本站立场,本站不负责内容的准确性和版权。如果存在侵权、或不希望被转载的媒体或个人可与我们联系,我们将立即进行删除处理。
在此留言
评论区 (4)
#插入话题
  1. [GetPortalCommentsPageByObjectIdResponse(id=1831124, encodeId=e3031831124e5, content=<a href='/topic/show?id=1b6210686b2' target=_blank style='color:#2F92EE;'>#Lancet#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10686, encryptionId=1b6210686b2, topicName=Lancet)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f0227, createdName=howi, createdTime=Sat Sep 11 01:15:16 CST 2021, time=2021-09-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1511881, encodeId=2ee7151188168, content=<a href='/topic/show?id=d88b891e376' target=_blank style='color:#2F92EE;'>#血流感染#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89173, encryptionId=d88b891e376, topicName=血流感染)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=83b410387887, createdName=ms6829001416292975, createdTime=Mon Apr 19 02:15:16 CST 2021, time=2021-04-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1034273, encodeId=bf2510342e36f, content=顶刊就是不一样,质量很高,内容精彩!学到很多, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=goodbing, createdTime=Sat Apr 17 14:15:16 CST 2021, time=2021-04-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=957802, encodeId=1bbf95e802eb, content=1, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=5abd5478986, createdName=ms1000001313046333, createdTime=Sat Apr 17 11:26:35 CST 2021, time=2021-04-17, status=1, ipAttribution=)]
    2021-09-11 howi
  2. [GetPortalCommentsPageByObjectIdResponse(id=1831124, encodeId=e3031831124e5, content=<a href='/topic/show?id=1b6210686b2' target=_blank style='color:#2F92EE;'>#Lancet#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10686, encryptionId=1b6210686b2, topicName=Lancet)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f0227, createdName=howi, createdTime=Sat Sep 11 01:15:16 CST 2021, time=2021-09-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1511881, encodeId=2ee7151188168, content=<a href='/topic/show?id=d88b891e376' target=_blank style='color:#2F92EE;'>#血流感染#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89173, encryptionId=d88b891e376, topicName=血流感染)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=83b410387887, createdName=ms6829001416292975, createdTime=Mon Apr 19 02:15:16 CST 2021, time=2021-04-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1034273, encodeId=bf2510342e36f, content=顶刊就是不一样,质量很高,内容精彩!学到很多, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=goodbing, createdTime=Sat Apr 17 14:15:16 CST 2021, time=2021-04-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=957802, encodeId=1bbf95e802eb, content=1, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=5abd5478986, createdName=ms1000001313046333, createdTime=Sat Apr 17 11:26:35 CST 2021, time=2021-04-17, status=1, ipAttribution=)]
  3. [GetPortalCommentsPageByObjectIdResponse(id=1831124, encodeId=e3031831124e5, content=<a href='/topic/show?id=1b6210686b2' target=_blank style='color:#2F92EE;'>#Lancet#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10686, encryptionId=1b6210686b2, topicName=Lancet)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f0227, createdName=howi, createdTime=Sat Sep 11 01:15:16 CST 2021, time=2021-09-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1511881, encodeId=2ee7151188168, content=<a href='/topic/show?id=d88b891e376' target=_blank style='color:#2F92EE;'>#血流感染#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89173, encryptionId=d88b891e376, topicName=血流感染)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=83b410387887, createdName=ms6829001416292975, createdTime=Mon Apr 19 02:15:16 CST 2021, time=2021-04-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1034273, encodeId=bf2510342e36f, content=顶刊就是不一样,质量很高,内容精彩!学到很多, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=goodbing, createdTime=Sat Apr 17 14:15:16 CST 2021, time=2021-04-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=957802, encodeId=1bbf95e802eb, content=1, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=5abd5478986, createdName=ms1000001313046333, createdTime=Sat Apr 17 11:26:35 CST 2021, time=2021-04-17, status=1, ipAttribution=)]
    2021-04-17 goodbing

    顶刊就是不一样,质量很高,内容精彩!学到很多

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=1831124, encodeId=e3031831124e5, content=<a href='/topic/show?id=1b6210686b2' target=_blank style='color:#2F92EE;'>#Lancet#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10686, encryptionId=1b6210686b2, topicName=Lancet)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f0227, createdName=howi, createdTime=Sat Sep 11 01:15:16 CST 2021, time=2021-09-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1511881, encodeId=2ee7151188168, content=<a href='/topic/show?id=d88b891e376' target=_blank style='color:#2F92EE;'>#血流感染#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89173, encryptionId=d88b891e376, topicName=血流感染)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=83b410387887, createdName=ms6829001416292975, createdTime=Mon Apr 19 02:15:16 CST 2021, time=2021-04-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1034273, encodeId=bf2510342e36f, content=顶刊就是不一样,质量很高,内容精彩!学到很多, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=goodbing, createdTime=Sat Apr 17 14:15:16 CST 2021, time=2021-04-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=957802, encodeId=1bbf95e802eb, content=1, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=5abd5478986, createdName=ms1000001313046333, createdTime=Sat Apr 17 11:26:35 CST 2021, time=2021-04-17, status=1, ipAttribution=)]
    2021-04-17 ms1000001313046333

    1

    0