In-line filters in central venous catheters in a neonatal intensive care unit.
Nosocomial sepsis remains an important cause of morbidity in neonatal intensive care units. Central venous catheters (CVCs) and parenteral nutrition (TPN) are major risk factors. In-line filters in the intravenous (IV) administration sets prevent the infusion of particles, which may reduce infectious complications. We randomized infants to in-line filter (for clear fluids and lipid emulsions) or no filter placement. Sepsis, nursing time and costs were assessed. IV sets without filters were changed every 24 h, IV-sets with filters every 96 h. Of 442 infants with a CVC, 228 were randomized to filter placement, 214 to no filter. No differences were found in clinical characteristics, CVC-use, and catheter days. Nosocomial sepsis occurred in 37 (16.2%) infants with filters, in 35 (16.3%) in the group without filter (NS). Nursing time to change the IV-administration sets was 4 min shorter in the filter-group (P<0.05). Costs of materials used were comparable. In conclusion, the incidence of sepsis when using filters was not reduced but the nursing time for changing the intravenous sets was reduced without a difference in costs.
Wilhelmina Children's Hospital, University Medical Center Utrecht, 3508 AB Utrecht, The Netherlands.
Agnes
A
van den Hoogen
Tannette G
TG
Krediet
Cuno S P M
CS
Uiterwaal
Jeroen F G A
JF
Bolenius
Leo J
LJ
Gerards
André
A
Fleer
D002405:Catheterization, Central Venous / Q000009:adverse effects / Q000191:economics / Q000295:instrumentation*; D004866:Equipment Contamination / Q000517:prevention & control; D005374:Filtration / Q000191:economics / Q000295:instrumentation; D006801:Humans; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000209:etiology / Q000517:prevention & control*; D007262:Infusions, Intravenous / Q000295:instrumentation; D007363:Intensive Care Units, Neonatal; D010289:Parenteral Nutrition, Total / Q000295:instrumentation / Q000379:methods; D018805:Sepsis / Q000209:etiology / Q000517:prevention & control*; D013997:Time Factors