CENTRAL VENOUS CATHETER SEPSIS WITH WEEKLY CATHETER CHANGE IN PEDIATRIC BURN PATIENTS - AN ANALYSIS OF 221 CATHETERS

To document the risk of catheter er sepsis associated with central ven ous catheter changes every 7 days in paediatric burn patients, an anal ysis of data collected prospectively on 234 such catheters was perform ed. During an 18-month period there were 301 acutely burned children a dmitted to a regional paediatric burn Facility of whom 53, with an ave rage burn size of 42 per cent TBSA, required 234 central venous cathet ers. A central venous catheter management protocol was followed which included catheter changes every 7 days. IF insertion sites were clean and uninflamed, catheters were replaced by guidewire and the original catheter tip was semiquantitatively cultured. Catheters weve replaced to a new site if insertion sites appeared inflamed or catheter tips gr ew 15 or more colony forming units. Overall, 3.2 per cent (10.9 per ce nt by Centers far Disease Control definition) of central venous cathet ers were associated with sepsis. When catheters were replaced by guide wire from one to three times, catheter sites were used for a mean of 1 5.6 days without an increased rate of line sepsis. There was no differ ence in sepsis rates between catheters placed at a new site or replace d by guidewire. There were no deaths attributed to catheter-related se psis. We conclude that a protocol allowing For catheter change to a ne w site, or replacement by guidewire, every 7 days was associated with a low risk of catheter sepsis in paediatric burn patients.