Preventing driveline infection during left ventricular assist device support by the HeartMate 3: A survey-based study.
Preventing driveline infection during left ventricular assist device support by the HeartMate 3: A survey-based study.
复制标题
在 HeartMate 3 的左心室辅助装置支持期间预防动力传动系统感染：一项基于调查的研究。
DOI：
10.1111/aor.14187
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发表时间：
2022
影响因子：
2.4
通讯作者：
Barati,Edo
中科院分区：
文献类型：
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作者：
Saeed,Omar;Moss,Noah;Barrus,Bryan;Vidula,Himabindu;Shah,Samit;Feitell,Scott;Masser,KristiS;Kilic,Arman;Moin,Danyaal;Atluri,Pavan;Barati,Edo
目的传动系感染 (DLI) 是左心室辅助装置 (LVAD) 支持期间发病率和死亡率的重要来源，但可用于描述中心级患病率、预防措施及其潜在有效性的研究有限。方法我们调查了美国的 LVAD 中心，以确定 HeartMate (HM) 3 支持期间 DLI 的项目负担和预防措施。一项在线、匿名、基于问题的调查已发送给植入中心的专家提供者。每个中心只有一名受访者完成了调查。作为一项探索性分析，我们比较了报告 DLI 患病率低（≤10%）和高（>10%）的中心之间的具体 DLI 预防措施。结果 78 个中心对调查做出了答复（答复率：50%）。受访者包括 37 名 (47%) 心力衰竭心脏病专家、27 名 (35%) LVAD 协调员和 14 名 (18%) 心胸外科医生。据报告，HM3 期间 DLI 患病率≤10%（27 个中心（35%））、11%–25%（36 个中心（46%））和 >25%（16 个中心（19%））。 13 个中心 (17%) 设定了装置放置的体重指数阈值，29 个中心 (37%) 使用反切口，66 个中心 (81%) 放置了锚定缝线，69 个中心 (88%) 使用外部装置来稳定 DL。按比例来说，与高 DLI 患病率的中心相比，更多 DLI 患病率较低的中心使用伤口真空吸尘器 6 (22%) 与 3 (6%，p= 0.03)。结论 在 HM3 支持期间，各中心报告的患病率以及预防和管理传动系统感染的做法存在差异。需要进一步研究来制定和评估标准化预防策略的有效性。
PurposeDriveline infection (DLI) is a significant source of morbidity and mortality during left ventricular assist device (LVAD) support yet limited studies are available to describe the center‐level prevalence, preventive practices, and their potential effectiveness.MethodsWe surveyed LVAD centers in the United States to determine program burden and preventive practices for DLI during HeartMate (HM) 3 support. An online, anonymous, question‐based survey was sent to expert providers at implanting centers. Only a single respondent completed the survey for each center. As an exploratory analysis, we compared specific DLI preventive practices between centers with low (≤10%) and high (>10%) reported prevalence of DLI.ResultsSeventy‐eight centers responded to the survey (response rate: 50%). Respondents were comprised of 37 (47%) heart failure cardiologists, 27 (35%) LVAD coordinators, and 14 (18%) cardiothoracic surgeons. The prevalence of DLI during HM3 was reported as ≤10% by 27 (35%), 11%–25% by 36 (46%), and >25% by 16 (19%) centers. Thirteen (17%) centers had a body mass index threshold for device placement, 29 (37%) utilized a counter incision, 66 (81%) placed an anchor stitch, and 69 (88%) used an external device to stabilize the DL. Proportionally, more centers with a low DLI prevalence used a wound vacuum 6 (22%) versus 3 (6%,p= 0.03) than those with high DLI.ConclusionVariation exists in reported prevalence and practices of preventing and managing driveline infections across centers during HM3 support. Further studies are warranted to develop and assess the effectiveness of standardized preventive strategies.