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Sepsis From Triple- vs Single-Lumen Catheters During Total Parenteral Nutrition in Surgical or Critically Ill Patients

Sepsis From Triple- vs Single-Lumen Catheters During Total Parenteral Nutrition in Surgical or... Abstract • We prospectively studied the infection rates for 59 triple-lumen (TLC) and 68 single-lumen (SLC) subclavian catheters during the administration of total parenteral nutrition (TPN) to surgical or critically ill patients. A standard protocol was used for catheter insertion and maintenance. The infection control committee determined independently whether patients had catheter-related sepsis, an infected insertion site only, or no catheter infection. The TLCs had an increased incidence of catheter sepsis (19%) compared with the SLCs (3%). Low rates (5% for TLCs and 3% for SLCs) of infected catheter sites only indicated that the catheter care was comparable for both groups. The patients in the two groups were similar but not identical; those with TLCs appeared to be sicker and, therefore, at greater risk to develop catheter sepsis than patients with SLC. However, since TLCs were involved in six times more catheter sepsis than were SLCs, limiting the use of a subclavian catheter to giving TPN only and strict adherence to a TPN protocol are necessary to minimize the risk of catheter sepsis. (Arch Surg 1986;121:591-594) References 1. Sanderson I, Deitel M: Intravenous hyperalimentation without sepsis . Surg Gynecol Obstet 1973;136:577-585. 2. Dillon JD, Schaffner W, Van Way CW III, et al: Septicemia and total parenteral nutrition: Distinguishing catheter-related from other septic episodes . JAMA 1973;223:1341-1344.Crossref 3. Sanders RA, Sheldon GF: Septic complications of total parenteral nutrition: A five-year experience . Am J Surg 1976;132:214-220.Crossref 4. Wilmore DW, Dudrick SJ: Safe long-term venous catheterization . Arch 5. Goldman DA, Maki DG: Infection control in total parenteral nutrition . JAMA 1973;223:1360-1364.Crossref 6. Pemberton LB, Mandal J, Lyman B, et al: Developing a metabolic support service . Mo Med 1983;80:635-640. 7. Ryan JA Jr, Abel RM, Abbott WM, et al: Catheter complications in total parenteral nutrition . N Engl J Med 1974;290:757-761.Crossref 8. Miller JJ, Venus B, Mathru M: Comparison of long-term central venous catheterization using single lumen, triple lumen, and pulmonary artery catheters . Crit Care Med 1984:12:634-639.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Surgery American Medical Association

Sepsis From Triple- vs Single-Lumen Catheters During Total Parenteral Nutrition in Surgical or Critically Ill Patients

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References (11)

Publisher
American Medical Association
Copyright
Copyright © 1986 American Medical Association. All Rights Reserved.
ISSN
0004-0010
eISSN
1538-3644
DOI
10.1001/archsurg.1986.01400050109014
Publisher site
See Article on Publisher Site

Abstract

Abstract • We prospectively studied the infection rates for 59 triple-lumen (TLC) and 68 single-lumen (SLC) subclavian catheters during the administration of total parenteral nutrition (TPN) to surgical or critically ill patients. A standard protocol was used for catheter insertion and maintenance. The infection control committee determined independently whether patients had catheter-related sepsis, an infected insertion site only, or no catheter infection. The TLCs had an increased incidence of catheter sepsis (19%) compared with the SLCs (3%). Low rates (5% for TLCs and 3% for SLCs) of infected catheter sites only indicated that the catheter care was comparable for both groups. The patients in the two groups were similar but not identical; those with TLCs appeared to be sicker and, therefore, at greater risk to develop catheter sepsis than patients with SLC. However, since TLCs were involved in six times more catheter sepsis than were SLCs, limiting the use of a subclavian catheter to giving TPN only and strict adherence to a TPN protocol are necessary to minimize the risk of catheter sepsis. (Arch Surg 1986;121:591-594) References 1. Sanderson I, Deitel M: Intravenous hyperalimentation without sepsis . Surg Gynecol Obstet 1973;136:577-585. 2. Dillon JD, Schaffner W, Van Way CW III, et al: Septicemia and total parenteral nutrition: Distinguishing catheter-related from other septic episodes . JAMA 1973;223:1341-1344.Crossref 3. Sanders RA, Sheldon GF: Septic complications of total parenteral nutrition: A five-year experience . Am J Surg 1976;132:214-220.Crossref 4. Wilmore DW, Dudrick SJ: Safe long-term venous catheterization . Arch 5. Goldman DA, Maki DG: Infection control in total parenteral nutrition . JAMA 1973;223:1360-1364.Crossref 6. Pemberton LB, Mandal J, Lyman B, et al: Developing a metabolic support service . Mo Med 1983;80:635-640. 7. Ryan JA Jr, Abel RM, Abbott WM, et al: Catheter complications in total parenteral nutrition . N Engl J Med 1974;290:757-761.Crossref 8. Miller JJ, Venus B, Mathru M: Comparison of long-term central venous catheterization using single lumen, triple lumen, and pulmonary artery catheters . Crit Care Med 1984:12:634-639.Crossref

Journal

Archives of Surgery – American Medical Association

Published: May 1, 1986

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