Implementation of chlorhexidine gluconate for central venous catheter site care at Siriraj Hospital, Bangkok, Thailand
Implementation of chlorhexidine gluconate for central venous catheter site care at Siriraj Hospital, Bangkok, Thailand
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DOI：
10.1016/j.ajic.2006.12.002
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发表时间：
2007-11-01
影响因子：
4.9
通讯作者：
Thamlikitkul, Visanu
中科院分区：
文献类型：
--
作者：
Balamongkhon, Bancherd;Thamlikitkul, Visanu
背景：一项比较葡萄糖酸氯己定与聚维酮碘溶液用于静脉导管部位护理的随机对照试验的荟萃分析和成本-效果分析发现，葡萄糖酸氯己定的使用显著降低了导管相关血流感染的风险，并且具有成本效益。该研究的目的是在Siriraj医院重症监护病房（icu）实施局部配制的葡萄糖酸氯己定中心静脉导管（CVC部位护理）。方法：对2006年1 - 7月在3个icu内需要CVC插入的312例患者进行研究。120名受试者接受2%葡萄糖酸氯己定加70%酒精治疗，192名受试者接受10%聚维酮碘作为CVC部位护理的消毒溶液。评估患者是否存在cvc相关感染以及2%葡萄糖酸氯己定在70%酒精中的任何不良反应。结果：在同一时期，接受2%葡萄糖酸氯己定和70%酒精治疗的CVC留置患者的crbsi发生率低于接受10%聚维酮碘治疗的CVC患者，分别为每1000 CVC天3.2次和5.6次（P = 0.06； OR, 3.26; 95% Cl: 0.97-10.92）。在70%酒精中使用2%葡萄糖酸氯己定未观察到不良反应。结论：当地配制的2%葡萄糖酸氯己定70%酒精用于西丽拉吉医院icu CVC部位护理安全、有效、高效。
Background: A meta-analysis and cost-effectiveness analysis of randomized controlled trials comparing chlorhexidine gluconate with povidone-iodine solutions for venous catheter site care found that the use of chlorhexidine gluconate significantly reduced the risk for catheter-related bloodstream infections and that it was cost-effective. The objective of the study was to implement locally formulated chlorhexidine gluconate for central venous catheter (CVC site care in intensive care units (ICUs) at Siriraj Hospital.Methods: The study was conducted in 312 subjects who needed CVC insertions in 3 ICUs from January to July 2006. One hundred twenty subjects received 2% chlorhexidine gluconate in 70% alcohol, whereas 192 subjects received 10% povidone-iodine as the antiseptic solution for CVC site care. The patients were assessed for CVC-related infections and for any adverse effects of 2 % chlorhexidine gluconate in 70% alcohol.Results: The incidence of CRBSIs in the indwelling CVC subjects who received 2 % chlorhexidine gluconate in 70 % alcohol was less than those who received 10% povidone-iodine during the same period, 3.2 versus 5.6 episodes per 1000 CVC days, respectively (P =.06; OR, 3.26; 95% Cl: 0.97-10.92). No adverse effects related to using 2% chlorhexidine gluconate in 70% alcohol were observed.Conclusion: The locally formulated 2 % chlorhexidine gluconate in 70 % alcohol was safe, effective, and efficient for CVC site care in ICUs at Siriraj Hospital.