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Korean J Crit Care Med > Volume 26(4); 2011 > Article
Korean Journal of Critical Care Medicine 2011;26(4): 245-249. doi: https://doi.org/10.4266/kjccm.2011.26.4.245
중화상 환자에서 중심정맥 카테터 감염: 쇄골하정맥과 대퇴정맥의 비교
푸른병원 마취통증의학과, *푸른병원 화상외과, †계명대학교 의과대학 의과학연구소
Central Venous Catheter-related Infection in Major Burn Patients: Comparison of Subclavian Vein and Femoral Vein
Young Ho Jang, Yong Hoon Son, Sang Kyu Kim, Joon Mo Park, Mi Young Lee, Jin Mo Kim
1Department of Anesthesiology and Pain Medicine, Pureun Hospital Burn Center, Daegu, Korea. weonjo@pnuyh.co.kr
2Department of Burn Surgery, Pureun Hospital Burn Center, Daegu, Korea.
3Institute of Medical Science, School of Medicine, Keimyung University, Daegu, Korea.
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.
Key Words: bacteremia; burn; catheter-related infections; catheters; intensive care units
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