Prospective comparison of two management strategies of central venous catheters in burn patients.
OBJECTIVE
Central venous catheters (CVCs) are associated with sepsis in burn patients. This study was undertaken to compare two strategies of CVC management in patients with major burn injuries.


METHODS
Forty-two burn patients with major burn injuries were randomly assigned to undergo site change every 48 hours of the CVC or to undergo wire guide exchange of the CVC every 48 hours at the same site.


METHODS
Catheter insertion site, distance from the burn wound, cultures of catheter tips, and blood cultures were obtained from all patients in a prospective manner.


RESULTS
There was no difference in the incidence of CVC sepsis between the two groups studied. CVCs inserted less than 5 cm from the burn wound developed bacterial contamination at an earlier time than CVCs inserted more than 5 cm from the burn wound.


CONCLUSIONS
There was no advantage to changing the CVC insertion site every 48 hours. Changing the CVC using the wire guide technique did not prevent, nor predict, CVC bacterial contamination.
Kealey
G P
GP
Department of Surgery, University of Iowa College of Medicine, Iowa City, USA.
Chang
P
P
Heinle
J
J
Rosenquist
M D
MD
Lewis
R W
RW
D001419:Bacteria / Q000302:isolation & purification; D002056:Burns / Q000628:therapy*; D002405:Catheterization, Central Venous / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D004866:Equipment Contamination; D006801:Humans; D015994:Incidence; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D018805:Sepsis / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D012867:Skin / Q000382:microbiology; D016019:Survival Analysis