Influence of protective measures after epidural catheter disconnection on catheter lumen colonization: an in vitro study
| Autor: | D. Scholle, A. Reich, F. Kipp, H. Freise |
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| Rok vydání: | 2014 |
| Předmět: |
Anesthesia
Epidural Microbiology (medical) medicine.medical_specialty Catheters medicine.medical_treatment Lumen (anatomy) Catheterization Meningitis Bacterial Staphylococcus epidermidis medicine Humans In vitro study Saline biology Ropivacaine business.industry General Medicine biology.organism_classification Bacterial Load Surgery Disinfection Epidural catheter Catheter Infectious Diseases Anesthesia Disconnection business medicine.drug |
| Zdroj: | Journal of Hospital Infection. 86:133-137 |
| ISSN: | 0195-6701 |
| DOI: | 10.1016/j.jhin.2013.12.001 |
| Popis: | Summary Background Epidural anaesthesia provides excellent pain therapy and reduces postoperative morbidity and mortality. Epidural haematoma and infection are catastrophic complications of this therapy. Following accidental catheter disconnection the choice is between reconnection and premature treatment termination. There is little experimental or clinical data guiding clinical decision-making after epidural catheter disconnection. Aim Investigation of the in vitro effects of clinically applied safety measures after epidural catheter disconnection. Methods The proximal 20mm of epidural catheters were submerged into a suspension of 1 × 10 8 cfu Staphylococcus epidermidis . Catheters were treated by the following potentially preventive measures: (i) cutting 2cm distal to the level of contamination, (ii) disinfection by spray–wipe, or (iii) employing ropivacaine 0.75% as flushing solution instead of normal saline. All measures were used alone, in a dual combination or all together as a triple intervention ( N = 10 catheters in each group). Control catheters were not treated. After 24h of culturing, bacterial growth of the eluates was recorded. Findings All control catheters showed positive cultures. All 49 eluates of catheters that were cut as a single, dual or triple intervention remained sterile. Disinfection prevented bacterial growth in eluate of only six catheters in single or dual interventions. Ropivacaine did not prevent any bacterial growth. Conclusion Only cutting of epidural catheters 20 mm distal to the level of contamination completely prevented bacterial growth. Disinfection might further reduce risk as an additive measure. This supports the clinical practice of catheter shortening and reconnection. The safe window of time and length of shortening needs to be further investigated. |
| Databáze: | OpenAIRE |
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