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 Vol. 15 No. 1, January 2006
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AAP Grand Rounds 15:5-6 (2006)
© 2006 American Academy of Pediatrics

CRITICAL CARE MEDICINE

Vancomycin-Heparin Lock Solution Decreases the Rate of Sepsis in Neonates

Source: Garland JS, Alex CP, Henrickson KJ, et al. A vancomycin-heparin lock solution for prevention of nosocomial bloodstream infection in critically ill neonates with peripherally inserted central catheters: a prospective, randomized trial. Pediatrics. 2005;116:e198–e205.[Abstract/Free Full Text]

The first 20% of the full text of this article appears below.

The authors from the Medical College of Wisconsin performed a randomized, double-blind trial at a community Level III NICU to determine the safety and efficacy of a twice-daily vancomycin-heparin solution (25 µg/mL vancomycin in 0.4 mL of heparinized saline) in the prevention of catheter-related blood stream infections (CRBSI) among neonates with peripherally inserted central catheters (PICCs) in place for at least 48 hours. Neonates were randomized to have the PICCs locked with either the vancomycin-heparin solution or heparinized normal saline 2 or 3 times a day for 20- or 60-minute intervals. Catheter care including sterile barriers during insertion, site disinfection, and intravenous tubing changes were standardized and did not differ between groups. Needleless ports were not used for the trial.

Rectal and axillary cultures were collected at study entry and at the time of catheter removal for colonization with vancomycin-resistant organisms. Serum vancomycin levels were drawn on study days 7 and . . . [Full Text of this Article]

Gitte Larsen, MD, MPH, FAAP
Pediatrics, University of Utah, Salt Lake City, UT

 





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