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Cerrahi yoğun bakım ünitesinde kateter kaynaklı enfeksiyonlar

Catheter related infections in a surgical intensive care uni

Journal Name:

  • Gülhane Tıp Dergisi

Publication Year:

  • 2008

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Abstract (2. Language): 
Central venous catheterization is commonly used in critically ill patients and may cause many different complications. The objective of this study was to analyze the incidence of catheter related local infections and bacteremia regarding the use of different catheter port sites in patients followed up postoperatively in the surgical intensive care unit. The patients followed up at our surgical intensive care unit between May 2005 and February 2006 were classified on the basis of anatomic sites of inserted catheter, duration of catheterization and hospitalization, number of lumen of the catheter, duration of total parenteral nutrition, and APACHE and SOFA scores. A total of 101 catheterization procedures were performed to 88 patients. Of these, 79 (81.8%) were juguler catheters, 21 (17%) were subclavian catheters and 1 (1.2%) was peripherally located central catheter. Duration of total catheterization was 542 days for juguler catheters and 193 days for subclavian catheters. Catheter related infection density was statistically significantly higher in juguler catheters when compared to subclavian catheters (p<0.05). Most commonly isolated microorganism from catheter tip cultures of the patients was coagulase-negative staphylococcus. Duration of catheterization and type of catheter insertion site are important risk factors in catheter related infections. In order to minimize the rate of catheter related infections subclavian catheters should be preferred rather than juguler catheters, and preventive measures should be taken in decreasing the incidence of postoperative infections by following the patients closely
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Abstract (Original Language): 
Santral venöz kateterizasyon, durumu kritik hastalarda sıklıkla kullanılmaktadır ve çok farklı komplikasyonlara da yol açabilir. Bu çalışmanın amacı operasyon sonrası cerrahi yoğun bakım ünitesinde takip edilen hastalarda farklı kateter giriş yerleri kullanımı açısından kateter kaynaklı lokal enfeksiyon ve bakteriyemi insidansını analiz etmektir. Mayıs 2005 ile Şubat 2006 tarihleri arasında cerrahi yoğun bakım ünitesinde izlenen hastalar kateter giriş yerleri, yoğun bakım ve kateterizasyon süresi, lümen sayısı, total parenteral nütrisyon süresi ve APACHE ile SOFA skoru açısından sınıflandırıldı. Seksen sekiz hastaya toplam 101 kateter takıldı. Bunlardan 79’u jügüler kateter (%81.8), 21’i subklavyen kateter (%17) ve 1’i perifer lokalizasyonlu santral kateter (%1.2) idi. Kateter kalış süresi jügüler kateter için 542 gün, subklavyen kateter için 193 gündü. Kateter kaynaklı enfeksiyon dansitesi jügüler kateterlerde subklavyen kateterlere göre istatistiksel olarak daha yüksek bulunmuştur (p<0.05). Kateter ucu kültürlerinden en sık izole edilen mikroorganizma 14 hastada koagülaz negatif stafilokok idi. Kateter giriş yeri ve kalış süresi, kateter kaynaklı enfeksiyonlarda önemli bir risk faktörüdür. Kateter kaynaklı enfeksiyonları en aza indirmek için subklavyen kateter, diğer kateter giriş yerlerine göre öncelikle tercih edilmeli ve postoperatif dönemde enfeksiyonların azaltılmasında hastalar yakından takip edilerek önleyici tedbirler mutlaka alınmalıdır.
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  • 3
158-163
  • Turkish

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