196. Novel use of Tunneled Intravenous Catheters to Decrease Central Line Associated Blood Stream Infections in Patients with Severe Burns
Session: Poster Abstract Session: Catheter-associated BSIs
Thursday, October 3, 2013
Room: The Moscone Center: Poster Hall C
Posters
  • Novel Use of Tunneled Catheter SHEA 2013.pdf (270.4 kB)
  • Background:

    Central line associated blood stream infections (CLABSI) are a major cause of morbidity and mortality in burn patients.  The loss of the skin barrier makes CLABSI a common complication in the burn patient. Tunneled catheters (TC) are associated with less risk of CLABSI but are not used in burn patients. A pilot non-randomized study was conducted to investigate the safety and efficacy of TC in decreasing CLABSI in patients with severe burns.

    Methods:

    The study was conducted in a 9 bed Trauma Burn unit in a tertiary care academic medical center with an average of 300 burn injury admissions per year. Beginning July 1, 2012, the policy of the Trauma Burn Unit was changed to allow the insertion of central line TC for patients with >40% burns of total body surface area (TBSA). A 9.5 French double lumen catheter with a Dacron tissue ingrowth cuff was surgically placed. The number of mortalities and number of CLABSI was measured and compared to the previous two years’ experience in the burn population with >40% TBSA. Patients who died within 48 hours of admission were excluded from the analysis.

    Results:

    Total # patients with >40%TBSA 

    # CLABSI

    # Mortalities

    FYTD 2013

    7

    0

    1

    FY2012

    11

    4

    6

    FY2011

    5

    1

    2

    A total of 7 patients met the criteria with >40% TBSA burns between July 1, 2012 and March 31, 2013. Line days for TC ranged from 7 to 45 days with a mean average of 28 days during this 9 month pilot study. No CLABSI occurred in the patients with TC. There was no associated increased risk or complications. The number of mortalities was also lower during the pilot study than in the previous 2 years. 

    Conclusion:

    This is a novel approach to decrease CLABSI in patients with severe burns. Placement of TC in patients with severe burns was associated with decreased CLABSI as compared to the historical cohort. The results of the pilot study support the need for a larger randomized clinical trial to study this intervention further.

    C. Marie Dalton, RN, UPMC Mercy, Pittsburgh, PA, Jenny Ziembicki, MD, Surgery, UPMC, Pittsburgh, PA, Holt Murray, MD, CCM, University of Pittsburgh, Pittsburgh, PA, Alan Corcos, MD, Surgery, UPMC Mercy, Pittsburgh, PA, Juliet Ferrelli, MS, MT(ASCP), CIC, Infection Control, University of Pittsburgh Medical Center, Pittsburgh, PA and Mohamed Yassin, MD, PhD, Medicine, University of Pittsburgh Medical Center Mercy, Pittsburgh, PA

    Disclosures:

    C. M. Dalton, None

    J. Ziembicki, None

    H. Murray, None

    A. Corcos, None

    J. Ferrelli, None

    M. Yassin, None

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