The value of protective isolation procedures in cardiac allograft recipients.
The impact of protective isolation on the incidence of infection in 60 cardiac transplant recipients (mean age, 49.2 years) was studied in a prospective randomized trial. Thirty patients were randomized to protective isolation, which consisted of private room, hat, mask, sterile gown, and handwashing. Thirty patients were randomized to no isolation, which meant they recovered in a crowded, open intensive care unit and were adjacent to recipients of liver transplants or patients who were on the trauma, neurosurgical, and general surgical services, many of whom had an infection of the incision or a pulmonary infection. There was no difference between groups in the proportion of patients in whom infection developed (chi 2[1] = 0.27; p = 0.6), the number of infection-related deaths (2 in each group), the types of infection (bacterial, viral, fungal, or protozoal), or the overall outcome. Because protective isolation offered no benefit over standard care in protecting these patients from infections or the associated complications, we have discontinued its routine use after cardiac transplantation.
Walsh
T R
TR
Department of Surgery, University of Pittsburgh, Pennsylvania.
Guttendorf
J
J
Dummer
S
S
Hardesty
R L
RL
Armitage
J M
JM
Kormos
R L
RL
Griffith
B P
BP
D000293:Adolescent; D000328:Adult; D005069:Evaluation Studies as Topic; D005260:Female; D016027:Heart Transplantation; D006801:Humans; D017053:Infection Control; D007239:Infections / Q000453:epidemiology / Q000401:mortality; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010356:Patient Isolation; D011183:Postoperative Complications / Q000453:epidemiology / Q000401:mortality / Q000517:prevention & control*; D011446:Prospective Studies; D011897:Random Allocation; D012086:Reoperation