Abstract
Objective: The purpose of this study is to compare chlorhexidine gluconate (CHG)-impregnated dressing and standard dressing with respect to their effects on the frequency of central-line associated bloodstream infection (CLABSI), catheter related bloodstream infection (CRBSI), primary bloodstream infection (BSI) and catheter colonization in critically ill pediatric patients with short-term central venous catheter.Methods: Prospective, single-center randomized controlled trial performed in pediatric intensive care unit (PICU) of a tertiary referral hospital. The patients were randomized with respect to the type of catheter fixation they had received, either with CHG-impregnated dressing or standard dressing.Results: A total of 307 patients (151 CHG-impregnated dressing, 156 standard dressing), with 307 catheters amounting to a collective total of 4993 catheter days, were included in the study. Use of CHG impregnated dressing did not significantly decrease the incidence of CLABSI (6.36 per 1000 catheter days vs. 7.59 per 1000 catheter days; HR: 0.93, P = 0.76), CRBSI (3.82 per 1000 catheter days vs. 4.18 per 1000 catheter days; HR: 0.98, P = 0.98), primary BSI (2.54 per 1000 catheter days vs. 3.42 catheter days; HR: 0.39, P = 0.67). CHG-impregnated dressing significantly decreased the incidence of catheter colonization (3.82 per 1000 catheter days vs. 7.59 per 1000 catheter days; HR: 0.40, P = 0.04). Longer catheter time-in-place and use of blood product transfusion were found to be independently associated with CLABSI.Conclusions: The use of CHG-impregnated dressing does not significantly decrease CLABSI incidence in critically ill pediatric patients compared to standard dressing, but it is effective in reducing catheter colonization.
The metabolic effects of multi-trace elements on parenteral nutrition for critically ill pediatric patients: a randomized controlled trial and metabolomic research
