ブックタイトルカテーテル関連尿路感染の予防のためのCDCガイドライン 2009｜株式会社メディコン

概要

カテーテル関連尿路感染の予防のためのCDCガイドライン 2009｜株式会社メディコン

Evidence Review Table 1B. What are the risk factors for CAUTI?1B.1. Following aseptic insertion of the urinary catheter, maintain a closed drainage system.(Category IB) a1B.2. Insert catheters only for appropriate indications, and leave in place only as long asneeded. (Category IB) b1B.3. Minimize urinary catheter use and duration of use in all patients, particularly those athigher risk for CAUTI such as women, the elderly, and patients with impaired immunity.(Category IB)1B.4. Ensure that only properly trained persons (e.g., hospital personnel, family members, orpatients themselves) who know the correct technique of aseptic catheter insertion andmaintenance are given this responsibility. (Category IB)1B.5. Maintain unobstructed urine flow. (Category IB) caMore data are available under Question 2B.bMore data are available under Question 2C.cMore data are available under Question 2D.Q1C. What populations are at highest risk of mortality from urinary catheters?To answer this question, we reviewed the quality of evidence for those risk factors examined inmore than one study. The evidence for this question consists of 2 observational studies. 7,74 Thefindings of the evidence review and the grades for all important outcomes are shown in EvidenceReview Table 1C.Low-quality evidence suggested that older age, higher severity of illness, and being on an internalmedicine service compared to a surgical service were independent risk factors for mortality inpatients with indwelling urinary catheters. Both studies evaluating these risk factors found thehighest risk of mortality in patients over 70 years of age. Low-quality evidence also suggestedthat CAUTI was a risk factor for mortality in patients with catheters.Evidence Review Table 1C. What populations are at highest risk of mortality fromcatheters?1C.1. Minimize urinary catheter use and duration in all patients, particularly those who maybe at higher risk for mortality due to catheterization, such as the elderly and patientswith severe illness. (Category IB)< 原文 > VIII. Evidence Review85