Effects Of Different Glycolipids Card For Catheter Central Venous Infection With Parenteral Nutrition

Objective: This study was aimed to compare the Influence of catheter-related infections(CRI)incidence of Parenteral nutrition support Through central venous catheter(CVC) with different Glycolipids Energy Supply ratio in ICU. Comparative and analysis the CRI incidence and spectrum of pathogens from the Three groups, Provide a reference for the prevention of CRI in clinical.Methods: Prospective, randomized, double-blinded, clinical controlled trial. 167 patients who were admitted to the intensive care unit and received PN were included in the study and randomly divided into three groups. group A(Glycolipids Energy Supply ratio 4:6),group B(Glycolipids Energy Supply ratio 5:5), group C(Glycolipids Energy Supply ratio 6:4),the incidence of CRI,catheter correlated spectrum of pathogens were compared. Of total calories supplied by 125.6KJ /(kg ? d) calculation. Observe the condition of the skin in the conduit outlet 2cm wide. Catheter infection is suspected, Respectively specimens from peripheral blood and blood collected by the central venous catheter blood cultures, Take the catheter tip and catheter removal(5cm) for bacterial culture. at the end of treatment or after removal the catheter catheters.With or without signs of infection, Take the catheter tip and catheter removal(5cm) for bacterial culture. Record peripheral blood, Catheters and catheter tip bacterial blood culture results, Calculate infection rates. We were respectively measured the levels of albumin、pre-albumin、Hemoglobin,Before treatment, 1d、3d and after the end of treatment. Repeated measurement data using SPSS17.0 statistical software for statistical analysis, Count data with frequency, percentage(%).All measurements data expressed as mean±standard deviation(x±s), c2test and descriptive statistics.Results: 1.Of these 167 patients,18 had CRI, the overall infection rate was 10.78%;2. There were significant differences in the incidence of CRI among three groups [group A5.36%(3/56),group B 5.26%(3/57),group C 22.22 %(12/54), c2 =10.868, P=0.004]; A total of 31 strains cultured in which G+bacteria 14(45.16%)、G-bacteria12(37.5%).Pathogens isolated included14 strains of gram-positive bacteria,12 strains of gram-negative bacteria, and 5 strains of fungi.The main pathogenic was gram-positive bacteria. 3.The level of Pre-albumin increased at the 1d,3d and the end of treatment, Compared with before treatment, there were no significant difference; however compared with there groups, the difference of Pre-albumin level were statistically significant. Albumin increased after treatment,compared with before treatment, there were significant differences. With prolonged of treatment time the hemoglobin gradually increased, but the difference was not statistically significant.Conclusions: 1. CRI occur in patients with parenteral nutrition and parenteral nutrition is related to Glycolipids ratio for the card, High glucose increases the risk for the card of central venous catheter infection. 2. CRI main pathogens were:Staphylococcus epidermidis,Acinetobacter baumannii and Staphylococcus aureus. 3. Three kinds Glycolipids ratio for parenteral nutrition, Can improve the nutritional status of patients, With the progress of treatment,the effect is more pronounced.