Driveline exit-site care protocols in patients with left ventricular assist devices: a systematic review.
Care
Dressing
Driveline
Driveline infection
Left ventricular assist device
Protocols
Journal
European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
ISSN: 1873-734X
Titre abrégé: Eur J Cardiothorac Surg
Pays: Germany
ID NLM: 8804069
Informations de publication
Date de publication:
11 09 2021
11 09 2021
Historique:
received:
29
10
2020
revised:
14
02
2021
accepted:
17
02
2021
pubmed:
9
5
2021
medline:
16
10
2021
entrez:
8
5
2021
Statut:
ppublish
Résumé
Driveline infections continue to be a significant complication following left ventricular assist device (LVAD) implantation. Driveline exit-site care is crucial for the prevention of infections; however, there are no uniform guidelines. The goal of this study was to provide an overview of the currently published driveline exit-site care protocols in patients with LVAD. A systematic literature review was performed. Studies before 15 December 2020 were included if the number of driveline infections was a primary outcome and the driveline exit-site care protocol was explained. Eleven articles were included in the systematic review, including 1602 patients with LVADs. The median of the frequency of driveline infections in the articles was 13.8% with a range of 0-52.6%. There was a marked variability in the methods of care of driveline exit sites, without a standardized driveline dressing technique in patients with LVADs. The frequency of driveline infections was 6-7.5% in studies using a dressing kit that included chlorhexidine, a silver-based dressing and an anchoring device. Furthermore, there was variability in the anchoring devices and the frequency of dressing changes, which varied from daily to weekly. No specific anchoring device or change frequency was found to be superior. Based on this systematic review, driveline exit care protocols that included chlorhexidine, a silver-based dressing, the use of an anchoring device and dressing kits might be best in reducing driveline infection rates. However, prospective studies with larger cohorts are needed to establish the optimal protocol for driveline exit-site care.
Identifiants
pubmed: 33963835
pii: 6272478
doi: 10.1093/ejcts/ezab195
pmc: PMC8434872
doi:
Types de publication
Journal Article
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
506-515Informations de copyright
© The Author(s) 2021. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery.
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