The optimal frequency for changing pressure monitoring tubing and flush
solution that minimizes
catheter-related infection and contains cost has not yet been established. We conducted a pilot study to examine the effects of three protocols on
catheter-related infection: group I, change of flush
solution and pressure monitoring tubing every 24 hours; group II, change of flush
solution every 24 hours and change of pressure monitoring tubing every 48 hours; group III, change of flush
solution and pressure monitoring tubing every 48 hours. Thirty
critically ill patients were randomly assigned to one of the three protocols. Semiquantitative cultures of the
solution from the flush bag and
catheter tip were obtained. Intervening variables were documented: duration of cannulization, number of entries into the system, presence of other invasive devices, white cell count, patient's temperature, presence of preexisting
infection, patient's age and diagnosis, use of
steroids and
antibiotics, and host risk factors for immunocompromise. All flush
solution cultures were negative for growth. Incidence of
catheter-related
bacteremia was zero. The cultures of four
catheter tips were positive for Staphylococcus epidermidis; none in group I, three in group II, and one in group III. The results of this pilot study suggest that there is no difference in the incidence of
catheter-related infection whether the change interval for flush
solution and pressure monitoring
solution is 24 or 48 hours. However, further study with a larger sample is needed.