Central venous device
infections are associated with increased physical and psychological morbidity, mortality,
length of stay, and costs. The aim of this study was to prove the efficacy of pulsatile
flushing to prevent the bacterial colonization of
vascular access devices. One hundred and forty four tests using 576
polyurethane short venous access
catheters were performed. Four
catheters per test were polluted with a
fibronectin-
serum albumin solution. Three were filled with a Staphylococcus aureus broth; one served as negative control. One contaminated
catheter was not flushed (positive control), and two were flushed (10 mL.sec(-1)) with
normal saline solution, either by ten successive boluses of 1 mL each or by one bolus of 10 mL. Each
catheter was cultivated. The S. aureus quantity observed after continuous
flushing was significantly higher than that observed after pulsative
flushing (P<0.001). Unflushed
catheters were 20.71 and 6.42 times more polluted than
catheters flushed with the pulsative method or the continuous method, respectively. Pulsative
flushing was at least twice as effective as continuous
flushing in reducing the S. aureus count. Pulsative
flushing is more effective than continuous
flushing in reducing the endoluminal contamination. Pulsative
flushing is a simple, effective, and inexpensive technique to reduce
catheter bacterial colonization.