Driveline dressings used in heartmate patients and local complications: A retrospective cohort.

Autor: Balestra N; Sírio-Libanês Hospital, 115 Dona Adma Jafet St, São Paulo, 01308-050, Brazil; Faculty of Nursing, University of Campinas (UNICAMP), 126 Tessália Vieira de Camargo St, Campinas, 13083-887, Brazil., Fredericks S; Daphne Cockwell School of Nursing, Toronto Metropolitan University, 350 Victoria St, Toronto, M5B 2K3, Canada., Silva AVCD; Sírio-Libanês Hospital, 115 Dona Adma Jafet St, São Paulo, 01308-050, Brazil., Rodrigues RCM; Faculty of Nursing, University of Campinas (UNICAMP), 126 Tessália Vieira de Camargo St, Campinas, 13083-887, Brazil., Nunes DP; Faculty of Nursing, University of Campinas (UNICAMP), 126 Tessália Vieira de Camargo St, Campinas, 13083-887, Brazil., Pedrosa RBDS; Faculty of Nursing, University of Campinas (UNICAMP), 126 Tessália Vieira de Camargo St, Campinas, 13083-887, Brazil. Electronic address: rpedrosa@unicamp.br.
Jazyk: angličtina
Zdroj: Heart & lung : the journal of critical care [Heart Lung] 2023 Nov-Dec; Vol. 62, pp. 271-277. Date of Electronic Publication: 2023 Aug 25.
DOI: 10.1016/j.hrtlng.2023.08.007
Abstrakt: Background: Patients with long-term ventricular assist devices (VAD) are predisposed to infection, bleeding, and pressure injuries at the insertion of the driveline. There is no consensus on a driveline dressing protocol. Chlorhexidine is often used to clean the driveline exit site and has been associated with lower rates of infection. For driveline coverage, bacteriostatic agents and transparent film have shown good results, but are costly. The same issue was associated with anchorage devices.
Objectives: The purpose of this study was to evaluate the types of dressings used in the driveline of patients using HeartMate (HM) and to describe the incidence density of local complications (infection, bleeding, and pressure injury) within 30 days postoperatively.
Methods: A retrospective cohort study was conducted and included 22 patients admitted to the Intensive Care Unit after implantation of HM II and III in a Brazilian private hospital.
Results: Several types of dressings were used in the drivelines. There were 22 different types of dressings. Dressing type 6 (Chlorhexidine, Excilon, Gauze and IV3000) were the most used (45.4%). Subjects using the Flexi-Trak anchoring device had a higher rate of local bleeding (50.0%) and those who used the Hollister device had more infection (61.1%) and pressure injury associated with a medical device (11.1%), compared to others. Infection was the primary complication (45.4%), followed by local bleeding (27.7%).
Conclusion: Despite the high variability of products used in the driveline of patients using HeartMate, the dressing made with chlorhexidine, silver-impregnated absorbent foam and transparent film, and the use of anchoring devices was the most frequently used. Infection was the most common complication.
Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2023 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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