Infections associated with implantable cardioverter defibrillators placed transvenously and via thoracotomies: Epidemiology, infection control, and management
Infections associated with implantable cardioverter defibrillators placed transvenously and via thoracotomies: Epidemiology, infection control, and management
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DOI：
10.1086/514673
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发表时间：
1998-08-01
影响因子：
11.8
通讯作者：
Fontecchio, SA
中科院分区：
文献类型：
--
作者：
Lai, KK;Fontecchio, SA
1993年，在我们的机构，与植入式心律转复除颤器（ICD）相关的感染发生率为16.7%，不包括发生器、电极导线和贴片放置。88%的ICD植入是两个阶段的程序：心脏病专家在他们的实验室进行电生理研究，几小时到几天后由心胸外科医生在手术室进行植入。1994年，电生理检查和ICD植入均在手术室进行，无需等待。从1993年到1995年，经胸植入ICD的比例从56%上升到100%，而两阶段植入ICD的比例从88%下降到零。从1992年到1993年，感染率从16.7%下降到零。从1992年到1995年，单独植入式ICD的感染率为4.8%，植入式ICD（包括发生器、电极导线和贴片置入）的总体感染率为6.9%，与文献中报告的感染率（2.2%-7.2%）相当。两阶段手术的取消和经皮植入ICD比例的增加有助于降低感染率。
In 1993, the incidence of infection associated with implantable cardioverter defibrillators (ICDs) excluding generator, lead, and patch placements was 16.7% at our institution. Eighty-eight percent of the ICD implantations were two-staged procedures: the cardiologists performed the electrophysiologic studies in their laboratories, and implantations were performed in the operating rooms a few hours to a few days later by cardiothoracic surgeons. In 1994, both the electrophysiologic studies and ICD implantations were performed in the operating rooms without waiting periods. From 1993 to 1995, the proportion of ICDs placed transvenously increased from 56% to 100%, whereas the proportion of two-staged ICD placements decreased from 88% to zero. From 1992 to 1993 the infection rate decreased concomitantly from 16.7% to zero. From 1992 through 1995, the infection rate for implantable ICDs alone was 4.8%, and the overall infection rate for implantable ICDs (including generator, lead, and patch placements) was 6.9%, comparable to the rate reported in the literature (2.2% to 7.2%). The elimination of the two-stage procedure and the increased proportion of transvenously placed ICDs has contributed to the decrease in infection rate.