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Effect of Fat Emulsion Hang Time Changes on Central Line-associated Bloodstream Infection Rates and Risk Factor Analysis in a Single Center Neonatal Intensive Care Unit
J. Kor. Soc. Health-syst. Pharm. 2019;36:344-352
Published online August 31, 2019;  https://doi.org/10.32429/jkshp.2019.36.3.004
© 2019 Korean Society of Health-System Pharmacists

Jae Kyoung Yuna, Hyun Jung Shina, Hye Jung Baea†, Yun Hee Joa, Yoon Sook Choa, Seung Han Shinb, Ee-Kyung Kima and Han-Suk Kimb

Department of Pharmacy, Seoul National University Hospitala Department of Pediatrics, Seoul National University Children’s Hospitalb 101, Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
Correspondence to: 배혜정 Tel:02-2072-3420 E-mail:baehj021004@hanmail.net
Received February 1, 2019; Revised February 25, 2019; Accepted June 26, 2019.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Background : Intravenous fat emulsions (IVFE) can promote pathogenic organisms to proliferate. Therefore, many guidelines recommend changing intravenous infusion sets for IVFE administration every 24 or 12 hours. In this study, we evaluated the effect of IVFE hang time on central line-associated bloodstream infection (CLABSI) rates and analyzed risk factors of CLABSI in a single center neonatal intensive care unit (NICU).
Methods : This is a retrospective study of NICU patients who were prescribed SMOFlipid? 20% 100mL emulsion from 1 January 2017 to 30 June 2018.
We divided the patients into two groups, based on IVFE hang time; 24 hours group (n=247) and 12 hours group (n=85).
Results : Demographic characteristics were similar between the two groups; except birth weight. Duration of hospital stay and catheter dwell time was longer in the 24 hours group. There was no significant difference in CLABSI rate between the two groups (1.60 vs. 1.52 per 1,000 catheter days in the 24 hours vs. 12 hours groups). Risk factor analysis indicated that prolonged hospitalization (≥80 days, p=0.048), longer catheter dwell time (≥35 days, p=0.001), duration of IVFE (≥14 days, p=0.034) and duration of total parenteral nutrition (≥7 days, p=0.031) were statically significant in univariable analysis. On multivariable analysis, catheter dwell time (odds ratio 10.73; 95% confidential interval 1.695- 67.926; p=0.012) was independently associated with the occurrence of CLABSI.
Conclusions : Shortening IVFE hang time from 24 hours to 12 hours did not alter CLABSI rate, and risk factor of CLABSI was catheter dwell time.
Keywords : Intensive care units, Neonatal; Fat emulsions, Intravenous; Central line-associated bloodstream infection


August 2019, 36 (3)