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Hector F. Gorbea, MD; David R. Snydman, MD; Annette Delaney, RN, MA; Jane Stockman, RN; William J. Martin, PhD

JAMA. 1984;251(16):2112-2115.

Abstract
No studies of safety in changing intravenous systems containing in-line burettes at 48 hours in an intensive care setting have been performed. Patients entering a surgical intensive care unit were alternatively assigned to have any line with an in-line burette changed at either 24-hour (64 patients) or 48-hour (59 patients) intervals. Daily quantitative cultures with a 2-mL aliquot of burette fluid were obtained. Contaminated burette fluid was detected in nine of 452 (2.0%; 95% confidence interval, 0.7% to 3.3%) samples from 24-hour interval burettes and in nine of 224 (4.0%; 95% confidence interval, 1.4% to 6.6%) samples from 48-hour interval burettes. Bacterial contamination of burette fluid with ten or more colonies per milliliter occurred in only five (1.1%) cultures from patients in the 24-hour interval group compared with only two cultures (0.9%) in the 48-hour group. None of the contaminated burette fluids was associated with primary bacteremia. Change of in-line burettes in patients in intensive care at 48-hour intervals is safe and should result in substantial cost savings.

(JAMA 1984;251:2112-2115)

Author Affiliations
From the Departments of Medicine, Infectious Disease Division (Drs Gorbea and Snydman), Nursing (Ms Stockman), and Pathology (Dr Martin), and the Quality/Utilization Review (Ms Delaney), New England Medical Center Hospital and Tufts University School of Medicine, Boston. Dr Gorbea is now with the Veterans Administration Medical Center, San Juan, Puerto Rico.

Footnotes
Reprint requests to Box 238, New England Medical Center, 171 Harrison Ave, Boston, MA 02111 (Dr Snydman).

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