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groups. Peripheral vascular failure may be a major determi- nant of outcome in sepsis, even if associated to inability to maintain elevated CI. (Reprinted with permission.)

Prospective Study of Catheter-Related Infection During

Prolonged Arterial Catheterization. Norwwd SH, Cormier B, McMahon NG. et al. Crit Care Med 16:836, 1988.

This prospective study examined the impact of prolonged arterial site use (>96 hr) on the incidence of catheter-related infection in ICU patients.

Ninety-six arterial catheters from 75 different sites in 56 surgical patients were studied. Sterile techniques were per- formed for line insertion and guide rewiring when lines stayed more than 96 hours. Flush solutions were replaced every 24 hours and transducer/pressure tubing systems every 48

hours. When catheter was removed or rewired, the old catheter was rolled on a blood agar plate using the semi- quantitative method (SQ). The site was swabbed and cul- tured. The arterial sites were used definitely as long as SQ cultures remained negative (515 colonies) and no local inflammation or purulent drainage occurred at the entry site.

No sites used t96 hr developed skin colonization while 14/51 sites used >96 hr developed positive swab cultures. There was no positive SQ culture in negative swab culture sites. A positive SQ culture occurred in 4/42 (9.5%) radial and femoral sites compared to 4/9 (44%) axillary sites used > 96 hrs (p < 0.01).

If skin colonization at the percutaneous site is well con- trolled, safe prolonged use of arterial catheters may be undertaken. (Reprinted with permission.)