Microbial contamination of arterial infusions used for hemodynamic monitoring: a randomized trial of contamination with sampling through conventional stopcocks versus a novel closed system.
Arterial catheters are now commonly used to monitor blood pressure and obtain blood samples for arterial blood gas and other laboratory determinations. Stopcocks inserted into the pressure monitoring circuit have been the primary means of obtaining blood from arterial catheters. However, these stopcock systems have been associated with nosocomial contamination and bacteremias. Because of the problems of bacterial contamination and blood wasting with the stopcock sampling systems, we compared the frequency and extent of contamination of external sampling ports and the monitoring tubing fluid in stopcocks with that of a novel closed needle-sampling system (Lab-Site, Migada Ltd, Rehovot, Israel), incorporated into pressure monitoring tubing (Abbott Laboratories Inc., North Chicago, Illinois). We found that use of the novel sampling system resulted in significantly fewer episodes of internal bacterial contamination of the arterial monitoring line (7%) than did the use of a stopcock system (61%). External contamination of the sampling port was also lower in the novel system (8%) than in the stopcock system (37%). This suggests that the closed system may reduce the risk of nosocomial infections in patients requiring arterial pressure monitoring.
Crow
S
S
Department of Infection Control, Louisiana State University Medical Center, Shreveport 71130-3932.
Conrad
S A
SA
Chaney-Rowell
C
C
King
J W
JW
D000328:Adult; D002408:Catheters, Indwelling; D003428:Cross Infection / Q000517:prevention & control; D004866:Equipment Contamination / Q000517:prevention & control*; D004867:Equipment Design; D004865:Equipment and Supplies, Hospital; D006801:Humans; D011897:Random Allocation; D018805:Sepsis / Q000517:prevention & control; D013997:Time Factors