BACKGROUND: Driveline infection (DLI) is a cause of morbidity and mortality in patients with continuous-flow left ventricular assist devices (CF-LVADs). We hypothesized that an alternate dressing protocol would decrease the rate of DLIs. METHODS AND RESULTS: A retrospective review of CF-LVAD implants at a single institution from January 2010 to October 2015 was conducted. Patients were divided into implants before (group 1) and after (group 2) the introduction of the new protocol on September 1, 2012. Patients were followed until death, transplantation, change in dressing type, or 2 years. 153 patients were included: 61 in group 1 and 92 in group 2. Group 1 had fewer HVADs than group 2 (27.9% vs 71.7%; P < .001) and more destination therapy, although the latter was not statistically significant (50.8% vs 34.8%; P = .118). At 24 months, the freedom from DLI was 53% in group 1 and 89% in group 2 (P = .01). Group 1 had a significantly greater risk of DLI than group 2 (incident rate ratio 3.18, 95% confidence interval 1.23-8.18; P = .016). CONCLUSIONS: Dramatic improvement in freedom from DLI at 2 years was achieved with a new driveline dressing protocol. This demonstrates that DLI rates can be improved with alternate percutaneous site care techniques in CF-LVAD patients.
BACKGROUND: Driveline infection (DLI) is a cause of morbidity and mortality in patients with continuous-flow left ventricular assist devices (CF-LVADs). We hypothesized that an alternate dressing protocol would decrease the rate of DLIs. METHODS AND RESULTS: A retrospective review of CF-LVAD implants at a single institution from January 2010 to October 2015 was conducted. Patients were divided into implants before (group 1) and after (group 2) the introduction of the new protocol on September 1, 2012. Patients were followed until death, transplantation, change in dressing type, or 2 years. 153 patients were included: 61 in group 1 and 92 in group 2. Group 1 had fewer HVADs than group 2 (27.9% vs 71.7%; P < .001) and more destination therapy, although the latter was not statistically significant (50.8% vs 34.8%; P = .118). At 24 months, the freedom from DLI was 53% in group 1 and 89% in group 2 (P = .01). Group 1 had a significantly greater risk of DLI than group 2 (incident rate ratio 3.18, 95% confidence interval 1.23-8.18; P = .016). CONCLUSIONS: Dramatic improvement in freedom from DLI at 2 years was achieved with a new driveline dressing protocol. This demonstrates that DLI rates can be improved with alternate percutaneous site care techniques in CF-LVADpatients.
Authors: Heidi S Lumish; Barbara Cagliostro; Lorenzo Braghieri; Bruno Bohn; Giulio M Mondellini; Karen Antler; Vivian Feldman; Audrey Kleet; Jennifer Murphy; Melie Tiburcio; Kathryn Fidlow; Douglas Jennings; Gabriel T Sayer; Koji Takeda; Yoshifumi Naka; Ryan T Demmer; Justin G Aaron; Nir Uriel; Paolo C Colombo; Melana Yuzefpolskaya Journal: ASAIO J Date: 2022-03-01 Impact factor: 3.826
Authors: Supriya Shore; Michael J Pienta; Tessa M F Watt; Gardner Yost; Whitney A Townsend; Lourdes Cabrera; Michael D Fetters; Carol Chenoweth; Keith D Aaronson; Francis D Pagani; Donald S Likosky Journal: J Heart Lung Transplant Date: 2021-10-22 Impact factor: 13.569
Authors: Jeffrey H Barsuk; Elaine R Cohen; Kenzie A Cameron; Kathleen L Grady; Jane E Wilcox; Kerry B Shanklin; Rebecca S Harap; Gretchen P Nonog; Diane B Wayne Journal: Clin Simul Nurs Date: 2021-02-15 Impact factor: 2.391
Authors: Melanie Kranzl; Martin Stoiber; Anne-Kristin Schaefer; Julia Riebandt; Dominik Wiedemann; Christiane Marko; Günther Laufer; Daniel Zimpfer; Heinrich Schima; Thomas Schlöglhofer Journal: Front Cardiovasc Med Date: 2021-12-16
Authors: Jane E Wilcox; Rebecca S Harap; Valentina Stosor; Elaine R Cohen; Kathleen L Grady; Kenzie A Cameron; Denise M Scholtens; Diane B Wayne; Kerry B Shanklin; Gretchen P Nonog; Lauren E Schulze; Alison M Jirak; Grace C Magliola; Jeffrey H Barsuk Journal: J Cardiovasc Nurs Date: 2022 May-Jun 01 Impact factor: 2.468