Closed Blood Conservation Device for Reducing Catheter-Related Infections in Children After Cardiac Surgery

Abstract

BACKGROUND Arterial catheters are potential sources of nosocomial infection. OBJECTIVE To investigate use of a closed blood conservation device in preventing catheter-related bloodstream infections in children after cardiac surgery. METHODS Children with an indwelling arterial catheter after cardiac surgery were randomly assigned to 2 groups: a control group with a conventional 3-way stopcock in the catheter system and an interventional group with the conservation device in the catheter system. Catheter tips, catheter intraluminal fluid, and blood samples obtained from the catheter and peripherally were cultured for microbiological analysis. RESULTS Intraluminal fluid contamination was significantly lower (P = .03) in the interventional group (3 of 147 catheters) than in the control group (10 of 137 catheters). The 2 groups did not differ significantly in the rate of tip colonization (9 of 147 vs 12 of 137; P = .40) or in the number of catheter-related bloodstream infections (0 of 147 vs 2 of 137; P = .21). CONCLUSION Use of a closed blood conservation device could decrease the incidence of catheter-related contamination of intraluminal fluid. (Critical Care Nurse. 2014;34[5]:53-61)

‘True Blood’ The Critical Care Story: An audit of blood sampling practice across three adult, paediatric and neonatal intensive care settings

“…closed systems, needleless connectors). [32][33][34] There are theoretical concerns regarding the reinfusing of line clearance fluid and the risk for hub contamination and thrombosis. There are some conditions for which the reinfusion of this fluid causes unacceptable risk of complication (e.g.…”

SHEA Neonatal Intensive Care Unit (NICU) White Paper Series: Practical approaches for the prevention of central-line–associated bloodstream infections

“…Previous studies have shown that closed infusion systems are associated with a decrease in overall CLABSI rates when compared to open infusion systems. Other studies have proposed that closed blood sampling systems, such as the venous arterial blood management and protection (VAMP™) and KidsKit™ systems, decrease system entry, blood waste, and microbial contamination (56)(57)(58). A pediatric study evaluated both systems and compared implementation of the KidsKit™ system to the conventional three-way stopcock methods used on umbilical arterial catheters in the PICU and NICU.…”

“…Other studies have proposed that closed blood-sampling systems, such as the venous arterial blood management and protection (VAMP TM ) and KidsKit TM systems, decrease system entry, blood waste, and microbial contamination. [55][56][57] A pediatric study evaluated both systems and compared implementation of the KidsKit system to the conventional 3-way stopcock methods used on umbilical arterial catheters in the PICU and NICU. The authors found a decrease in CLABSIs below the national benchmark.…”

Strategies for blood conservation in pediatric cardiac surgery

“…The use of a closed blood conservation device, the venous arterial blood management protection system, decreases the incidence of catheter-related contamination of the intraluminal fluid. [ 26 ]…”