Abstract: SA-OR41
Extra Aseptic Measures in Permanent Catheter Connection: Twister System, 6-Year Experience
Session Information
- Dialysis Vascular Access: Research Advances
October 26, 2024 | Location: Room 8, Convention Center
Abstract Time: 05:10 PM - 05:20 PM
Category: Dialysis
- 803 Dialysis: Vascular Access
Authors
- Suarez, Miguel, Servicio Extremeno de Salud, Merida, Spain
- Garcia Bernalt, Vanesa, Servicio Extremeno de Salud, Merida, Spain
- Dorado, Pedro, Universidad de Extremadura, Badajoz, Spain
Background
Hemodialysis requires venous access por its performed. Arteriovenous fistula is preferable due to less associated comorbidity compared to catheter. However, in some units, catheters are a highly prevalent access. Aseptic measures are required to prevent their intraluminal contamination, The guidlines recommen rates of less than 2 events/1,000 catheter-days. The TWISTER® reverse flow device (TWR) is a closed system device that allows the flow of a catheter to be reversed without the need to manually disconnect the blood lines, which reduces exposure to blood or connection systems to air or contact with non-sterile areas,, therefore reducing the risk of pathogens reaching the blood.
Methods
Retrospective study of 205 incident patients that compares the application of an extended aseptic protocol in the management of the catheter with the use of the Twisterr versus a standard protocol, as an extra measure to avoid bacteremia
Results
The number of bacteremias was 34; 2(3.6%) in the TWR group vs 32(24.4%) in the standard protocol; Confirmed bacteremia ratio by guideline criteria; 0.11 vs 0.81 /1000 catheter days. This represents a mean length of stay of 0.23+/-1.21 Vs 3.40+/-6.86 (p 0.001) in favor of the extended protocol and therefore reduces the total cost per 1000 catheter days; 4,884.6 Vs 5,992.08 euros in favor of TWR. In the binary logistic regression, the only factor (analyzed DM, Cardiopathy, catheter days, Starting Age, Sex and Chalson Index) with statistical significance is the center where the catheter is treated. P0,014
Conclusion
The use of the TWR system seems to be a useful tool in its fight. Among the weaknesses of the study are the non-randomization or extension to other areas. We believe that the design of studies for this purpose is necessary.