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Substantial Reduction in Driveline Infection Rates With the Modification of Driveline Dressing Protocol.

Abstract：

BACKGROUND:Driveline infection (DLI) is a cause of morbidity and mortality in patients with continuous-flow left ventricular assist devices (CF-LVADs). We hypothesized that an alternate dressing protocol would decrease the rate of DLIs. METHODS AND RESULTS:A retrospective review of CF-LVAD implants at a single institution from January 2010 to October 2015 was conducted. Patients were divided into implants before (group 1) and after (group 2) the introduction of the new protocol on September 1, 2012. Patients were followed until death, transplantation, change in dressing type, or 2 years. 153 patients were included: 61 in group 1 and 92 in group 2. Group 1 had fewer HVADs than group 2 (27.9% vs 71.7%; P < .001) and more destination therapy, although the latter was not statistically significant (50.8% vs 34.8%; P = .118). At 24 months, the freedom from DLI was 53% in group 1 and 89% in group 2 (P = .01). Group 1 had a significantly greater risk of DLI than group 2 (incident rate ratio 3.18, 95% confidence interval 1.23-8.18; P = .016). CONCLUSIONS:Dramatic improvement in freedom from DLI at 2 years was achieved with a new driveline dressing protocol. This demonstrates that DLI rates can be improved with alternate percutaneous site care techniques in CF-LVAD patients.

journal_name

J Card Fail

journal_title

Journal of cardiac failure

authors

Lander MM,Kunz N,Dunn E,Althouse AD,Lockard K,Shullo MA,Kormos RL,Teuteberg JJ

doi

10.1016/j.cardfail.2018.07.464

subject

Has Abstract

pub_date

2018-11-01 00:00:00

pages

746-752

issue

11

eissn

1071-9164

issn

1532-8414

pii

S1071-9164(18)30869-8

journal_volume

24

pub_type

杂志文章

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