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HEMODİYALİZ HASTALARINDA ÇİFT LÜMENLİ KATETERE BAĞLI İNFEKSİYONLARIN ÖNLENMESİNDE SEFAZOLİN İÇEREN HEPARIN SOLÜSYONUNUN ETKİSİ

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THE EFFECT OF CEFAZOLIN CONTAINING HEPARIN SOLUTION FOR PREVENTION OF DOUBLE LUMEN CATHETER RELATED INFECTIONS IN HEMODIALYSIS PATIENTS

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65-68

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Abstract (Original Language): 
Hemodiyaliz uygulaması için geçici damar yolu olarak çift lümenli kateterlerin sık olarak kullanılması ciddi infeksiyonlara neden olabilir. Hemodiyaliz için geçici damar yoluna gereksinimi olan 56 son dönem böbrek yetersizlikti (SDBY) veya akut böbrek yetersizlikti (ABY) hasta kateter tümenlerine diyalizler arası sürede kalmak üzere 2500 Ü/mlheparin (H) veya 2500 Ü/ml heparin ve 200 mcg/ml sefazolin (H+S) içeren solüsyon verilmek üzere tek kör olarak randomize edildiler. Sadece H kullanılan grupta 30 hasta (12 erkek, 18 kadın; 20 SDBY, 10 ABY) mevcut olup yaş ortalaması 42.5±17.9 idi. H+S kullanılan grupta ise 26 hasta (6 erkek, 20 kadın; 16 SDBY, 10 ABY) mevcuttu; yaş ortalaması 46.1 ±17.9 idi. Her iki grup arasında yaş, cinsiyet ve böbrek yetersizliğinin tipi açılarından anlamlı bir farklılık yoktu (p>0.05). Kateter kalış süreleri H ve H+S kullanılan gruplarda sırası ile 15.4±13.0 gün ve 19.5±5.2 gün olarak saptandı (p>0.05). Hkullanılan grupta 7 hastada kateter çıkış yeri infeksiyonu, 2 hastada katetere bağlı sepsis, 2 hastada katetere bağlı ateş, H+S kullanılan grupta ise, 4 hastada kateter çıkış yeri infeksiyonu ve 1 hastada katetere bağlı ateş gelişti (p>0.05). Sonuç olarak, 200 mcg/ml sefazolin içeren heparinli solüsyonun kateter tümenlerinde bırakılmasının katetere bağlı infeksiyonlan önlemede anlamlı bir etkisinin olmadığı, ancak daha uzun süreli kateter kullanılan geniş serilerde konunun araştırılması gerektiği kanısına varıldı.
Abstract (2. Language): 
Double lumen catheters, used as temporary vascular access for hemodialysis, may cause serious infectious complications. Fifty-six patients with end stage renal disease (ESRD) or acute renal failure (ARF), requiring temporary access for hemodialysis, were randomised to receive either 2500 U/ml heparin (H) or 2500 U/ml heparin plus 200 mcg/ml cefazolin (H+C) for catheter lumens to remain between dialysis sessions. There were 30 patients (12 M, 18 F; 20 ESRD, 10 ARF) in the H group and the mean age was 42.5±17.9, whereas there were 26patients (6 M, 20 F; 16 ESRD, 10 ARF) in the H+C group and the mean age was 46.1 ±17.9. There were no significant differences between the two groups for age, gender and the type of renal failure (p>0.05). Catheter remaining times for H and H+C groups were 15.4±13.0 days and 19.5±5.2 days, respectively (p>0.05). Seven catheter exit-site infections, two catheter related sepsis and two catheter related fever were detected in the H group, whereas four exit-site infections and one catheter related fever were found in the H+C group (p>0.05). In conclusion, 200 mcg/ml cefazolin containing heparin solution was not significantly efficient for preventing catheter related infections, but further studies containing more patients with longer catheter remaining times are needed.

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