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首页> 外文期刊>Infection >Influence of Prolonged Use of Intravenous Administration Sets in Paediatric Cancer Patients on CVAD-related Bloodstream Infection Rates and Hospital Resources.
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Influence of Prolonged Use of Intravenous Administration Sets in Paediatric Cancer Patients on CVAD-related Bloodstream Infection Rates and Hospital Resources.

机译：小儿癌症患者长期使用静脉给药对CVAD相关血流感染率和医院资源的影响。

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BACKGROUND: To assess the effects of extending the routine intravenous administration set (IVAS) change-interval from 72 h (group 1) to 7 days (group 2) on the incidence density for central venous access device (CVAD)-related bloodstream infections (BSIs) and on resource expenditures in a singlecentre pilot study. PROCEDURE: Prospective pre-/post-intervention comparison of two consecutive 12-month surveillance periods (2001-2003) in a 17-bed paediatric oncology tertiary care unit. IVAS changes and nosocomial infections (NIs) were prospectively analysed using a standardized unit-based surveillance system (Oncopaed NI). RESULTS: All 175 eligible patients were enrolled, 96 in group 1 and 79 in group 2. Both groups had similar distributions of primary diagnoses and risk factors. The proportion of IVAS changes performed after 3 days increased from 5.6% to 22.5%, but only 8% of IVASs in group 2 were changed after 7 days. Most IVAS changes (64.8% in group 1 and 92.9% in group 2) were done because of therapeutic interventions (blood products, parenteral nutrition [TNP]) before the scheduled endpoint. Overall, the rates and incidence densities of NIs were significantly lower during the second period. The corresponding results for CVAD-related BSIs did not show significant differences. No death attributable to a NI occurred. The '7-day' strategy resulted in cost savings for devices (3,300Dollars /year) and of nursing time (23 working days/year). CONCLUSIONS: Extending the routine IVAS change-interval from 3 days to 7 days appears to be safe and cost-effective in a paediatric oncology unit with high infection control standards and continuous surveillance for NIs. These results do not prove that 7-day intervals prevent infections, but they do suggest that this policy probably is not harmful and that a prospectively randomized study with sufficient power is needed.
机译：背景：为了评估将常规静脉内给药组（IVAS）的更改间隔从72小时（第1组）延长到7天（第2组）对中心静脉通路装置（CVAD）相关的血液感染的发生密度的影响（单中心试验研究中的BSI）和资源支出。程序：在一个有17张病床的儿科肿瘤三级护理部门中，对两个连续的12个月监测期（2001-2003年）进行干预前/干预后的前瞻性比较。使用标准化的基于单元的监视系统（Oncopaed NI）对IVAS的变化和医院感染（NIs）进行了前瞻性分析。结果：全部175名合格患者入组，第一组96例，第二组79例。两组的主要诊断和危险因素分布相似。 3天后进行IVAS改变的比例从5.6％增加到22.5％，但第2组中只有8％的IVAS在7天后发生了改变。大部分IVAS变化（第1组为64.8％，第2组为92.9％）是由于在预定终点之前进行了治疗性干预（血液制品，肠外营养[TNP]）而完成的。总体而言，在第二阶段，NI的发生率和发生密度显着降低。 CVAD相关的BSI的相应结果没有显示显着差异。没有发生可归因于NI的死亡。 “ 7天”策略节省了设备成本（3,300美元/年）和护理时间（23个工作日/年）。结论：在具有高感染控制标准和持续监测NIs的儿科肿瘤科中，将常规IVAS的间隔时间从3天延长至7天似乎是安全且具有成本效益的。这些结果不能证明7天的间隔可以预防感染，但是它们确实表明该策略可能无害，因此需要具有足够功效的前瞻性随机研究。

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