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Intravenous Tubing Containing Burettes Can Be Safely Changed at 72 Hour Intervals

Published online by Cambridge University Press:  02 January 2015

David R. Snydman*
Affiliation:
Departments of Medicine, Pathology and Epidemiology, New England Medical Center, Tufts University School of Medicine, Boston, Massachusetts
Maureen Donnelly-Reidy
Affiliation:
Departments of Medicine, Pathology and Epidemiology, New England Medical Center, Tufts University School of Medicine, Boston, Massachusetts
Linda K. Perry
Affiliation:
Departments of Medicine, Pathology and Epidemiology, New England Medical Center, Tufts University School of Medicine, Boston, Massachusetts
William J. Martin
Affiliation:
Departments of Medicine, Pathology and Epidemiology, New England Medical Center, Tufts University School of Medicine, Boston, Massachusetts
*
Box 238, New England Medical Center, 171 Harrison Avenue, Boston, MA 02111

Abstract

No studies testing the safety of changing intravenous systems containing in-line burettes at 72 hours in an intensive care setting have been performed. Patients entering a medical or surgical intensive care unit were alternatively assigned to have any line with an in-line burette changed at either 48 hour (105 patients) or 72 hour (65 patients) intervals. Daily quantitative cultures with a 2 ml aliquot of burette fluid were obtained. Contaminated burette fluid was detected in 60 of 1181 (5.0%, 95% confidence interval, 3.7% to 6.3%) samples from the burettes changed at 48 hour intervals, and in 40 of 901 (4.4%, 95% confidence interval, 3.0% to 5.8%) samples from 72 hour interval burettes. Significant bacterial contamination of burette fluid, defined as ten or more colonies per milliliter, occurred in only seven (0.6%) cultures from patients in the 48 hour interval group compared with only three (0.3%) cultures in the 72 hour group. None of the contaminated burette fluids was associated with a primary bacteremia. Change of inline burettes in patients in intensive care at 72-hour intervals is safe and should result in substantial cost savings to hospitals.

Type
Original Articles
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1987

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References

1.Gorbea, HF, Snydman, DR, Delaney, A, et al: Intensive care patients may have intravenous tubing with burettes safely changed at 48-hour intervals. JAMA 1984; 251:21122115.CrossRefGoogle ScholarPubMed
2.Buxton, AE, Highsmith, AK, Garner, JS, et al: Contamination of intravenous fluid: Effects of changing administration sets. Ann Inlern Med 1979; 90:764768.CrossRefGoogle ScholarPubMed
3.Band, JD, Maki, DG: Safety of changing intravenous delivery systems at longer than 24-hour intervals. Ann Intern Med 1979; 91:173178.CrossRefGoogle ScholarPubMed
4.Simmons, BP: CDC Guidelines for the prevention and control of nosocomial infections. Guideline for prevention of intravascular infections. Am J Infect Control 1983; 11:183188.CrossRefGoogle ScholarPubMed
5.Josephson, A: Changing intravenous tubing containing burettes. JAMA 1985; 253:42.CrossRefGoogle ScholarPubMed
6.Snydman, DR: Changing intravenous tubing containing burettes (reply). JAMMA 1985; 253:4243.CrossRefGoogle Scholar
7.Lennette, EH, Balows, A, Hansler, WJ Jr, et al: 1980 Manual of Clinical Microbiology, ed 3. Washington DC, American Society for Microbiology, 1980.Google Scholar
8.Maki, DG, Weise, CE, Sarafin, HW: A semiquantitative culture method for identifying intravenous-catheier-related infection. N Engl J Med 1977; 296:13051309.CrossRefGoogle ScholarPubMed
9.Maki, DG, Jarrett, F, Sarafin, HW: A semiquantitative culture method for identification of catheter-related infection in the burn patient. J Surg Res 1977; 22:513520.CrossRefGoogle ScholarPubMed
10.Snydman, DR, Murray, SA, Kornfeld, SJ, et al: Total parenteral nutrition-related infections. Prospective epidemiologic study using semiquantitative methods. Am J Med 1982; 73:695699.CrossRefGoogle ScholarPubMed
11.Pocock, SJ: Clinical Trials. A Practical Approach. New York, John Wiley and Sons, 1983, p 129130.Google Scholar
12.Josephson, A, Gombert, ME, Sierra, MF, et al: The relationship between intravenous fluid contamination and the frequency of tubing replacement. Infect Control 1985; 6:367370.CrossRefGoogle ScholarPubMed