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KMID : 0869620190360030344
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Journal of Korean Society of Hospital Pharmacists
2019 Volume.36 No. 3 p.344 ~ p.352
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Effect of Fat Emulsion Hang Time Changes on Central Line-associated Bloodstream Infection Rates and Risk Factor Analysis in a Single Center Neonatal Intensive Care Unit
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Yun Jae-Kyoung
Shin Hyun-Jung
Bae Hye-Jung
Jo Yun-Hee
Cho Yoon-Sook
Shin Seung-Han
Kim Ee-Kyung
Kim Han-Suk
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Abstract
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Background : Intravenous fat emulsions (IVFE) can promote pathogenic organisms to proliferate. Therefore, many guidelines recommend changing intravenous infusion sets for IVFE administration every 24 or 12 hours. In this study, we evaluated the effect of IVFE hang time on central line-associated bloodstream infection (CLABSI) rates and analyzed risk factors of CLABSI in a single center neonatal intensive care unit (NICU).
Methods : This is a retrospective study of NICU patients who were prescribed SMOFlipid? 20% 100mL emulsion from 1 January 2017 to 30 June 2018.
We divided the patients into two groups, based on IVFE hang time; 24 hours group (n=247) and 12 hours group (n=85).
Results : Demographic characteristics were similar between the two groups; except birth weight. Duration of hospital stay and catheter dwell time was longer in the 24 hours group. There was no significant difference in CLABSI rate between the two groups (1.60 vs. 1.52 per 1,000 catheter days in the 24 hours vs. 12 hours groups). Risk factor analysis indicated that prolonged hospitalization (≥80 days, p=0.048), longer catheter dwell time (≥35 days, p=0.001), duration of IVFE (≥14 days, p=0.034) and duration of total parenteral nutrition (≥7 days, p=0.031) were statically significant in univariable analysis. On multivariable analysis, catheter dwell time (odds ratio 10.73; 95% confidential interval 1.695- 67.926; p=0.012) was independently associated with the occurrence of CLABSI.
Conclusions : Shortening IVFE hang time from 24 hours to 12 hours did not alter CLABSI rate, and risk factor of CLABSI was catheter dwell time.
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KEYWORD
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Intensive care units, Neonatal, Fat emulsions, Intravenous, Central line-associated bloodstream infection
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