Antiseptic-impregnated central venous catheters: their evaluation in burn patients.

Central venous catheter-related infections are an important source of morbidity and mortality in burn patients. Antiseptic impregnated catheters have been recommended to prevent infections related to central venous lines in high-risk patients who require short-term catheters. This prospective, randomized, and controlled study compared the efficacy of standard and antiseptic devices in reducing catheter-related infections in burn patients. Twenty-two patients were included in the study with an average age of 47.6 yr and an average burned total body surface area of 38.7%. Thirty-eight silver-sulphadiazine, chlorhexidine catheters were compared with 40 non-antiseptic catheters. No differences in bacteraemia or colonization rates were observed between standard and antiseptic-coated catheters. Antiseptic catheters were more effective in reducing S. epidermidiscolonization than standard catheters (4% vs 31%, p < 0.01). However, Gram-negative bacilli were responsible more often than Gram-positive cocci for catheter tip colonization (53% vs 46%) and they were responsible for all the bacteraemias (5.1%) related to catheters in the present study. We conclude that antiseptic-impregnated catheters could be more effective for Gram-positive cocci and could therefore be less effective in patients with high Gram-negative bacilli bloodstream infection prevalence, as burn patients are.

[False aneurysm associated with mitral insufficiency due to rupture of the heart at the point of insertion of the anterior papillary muscle. A successfully operated case]. / Association faux anévrisme - insuffisance mitrale par rupture du coeur au point d'insertion du pilier antérieur. A propos d'un cas opéré avec succès.

Although rupture of a mitral papillary muscle during myocardial infarction is well known, and post-infarction transmural ruptures causing false aneurysms occasionally reported, the association of rupture of the anterior papillary muscle and a underlying transmural parietal rupture giving rise to a false aneurysm is quite exceptional, and, to the best of our knowledge, has not previously been reported. Despite the serious nature of the disease, surgical cure of the aneurysm with mitral valve replacement was successful, due to the limitation of the anatomical disruption by early pericardial symphysis.