Preventing catheter-related infections in children undergoing hemodialysis
Preventing catheter-related infections in children undergoing hemodialysis
复制标题
预防接受血液透析的儿童导管相关感染
DOI：
10.1586/eri.10.114
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发表时间：
2010
影响因子：
5.7
通讯作者：
C. Stefanidis
中科院分区：
文献类型：
--
作者：
C. Stefanidis
在接受长期血液透析的儿童中越来越多地使用隧道式套囊导管，这是由于其相对容易插入、无痛透析和立即使用。其使用的缺点是它们与导管相关菌血症（CRB）相关，而CRB又与发病率增加、通路丧失和偶尔的转移性感染甚至死亡相关。CRB可能难以诊断，通常与既往CRB病史、出口部位感染、低血清白蛋白和长期使用导管有关。有证据表明，动静脉内瘘的使用与较低的感染率有关。预防CRB的有效策略包括采取提高动静脉瘘发生率的政策，适当的手术导管插入和出口部位的最佳护理，以及安全的连接技术。最近，在许多随机临床试验中记录了抗菌导管溶液预防CRB的有效性。此外，在隧道套囊导管的出口部位应用抗生素软膏可能对减少葡萄球菌相关CRB具有重要意义。积极的一面是，以教育为基础的计划结合具体的预防措施可以显着减少CRB。
The increased use of tunneled cuffed catheters in children on chronic hemodialysis is the result of their relative ease of insertion, pain-free dialysis and immediate use. The disadvantage of their use is that they are associated with catheter-related bacteremia (CRB), which in turn is related with increased morbidity, access loss and occasionally metastatic infections and even death. A CRB might be difficult to diagnose and is often associated with a previous history of CRB, exit-site infection, low serum albumin and long duration of catheter use. There is evidence that the use of arteriovenous fistulae is associated with lower infection rates. The implementation of effective strategies for the prevention of CRBs include the adoption of policies for improving arteriovenous fistula rates, appropriate surgical catheter insertion and optimal nursing care of the exit site, and a safe connection technique. Recently, the effectiveness of antimicrobial catheter solutions for preventing CRB has been documented in a number of randomized clinical trials. In addition, the application of antibiotic ointments at the exit sites of tunneled cuffed catheters might be significant for the reduction of Staphylococcus-related CRB. The upside is that education-based programs combining specific preventive measures can significantly reduce CRBs.
影响因子：
13.6
作者：
Chavers, Blanche M.;Solid, Craig A.;Collins, Allan J.
通讯作者：
Collins, Allan J.