Heart failure is one of the major health problems affecting
considerable number of patients worldwide. Treatments of this condition vary
according to the severity of heart failure ranging from medications, valve
interventions, revascularization and mechanical supports. However, patients
with end stage heart failure transplant are considered a gold slandered choice.
Patients post heart transplant require aggressive management including
mechanical ventilation and hemodynamic monitoring by central lines.
catheter is a type of central line that will be inserted in critically ill
patients to administer fluids, medications, blood products, blood sampling, TPN
and hemodynamic monitoring. According to CDC guidelines, central lines have to
be inserted under sterile technique. Subclavian access is preferred over
femoral or jugular site in adult patient due to the lower infection rates. Central
line blood stream infection should be suspected in case of bacteremia in the
setting of central venous catheter without other apparent source of bacteremia.
Common pathogens causing CLABSI are gram positive or gram negative organism
such as E.coli, pseudomonas, Klebsiella pneumonia.
this topic showing higher incidence of CLABSI in cardiac surgical intensive
care unit is due to multiple risk factors including immune-compromised status
of this specific group of patients i.e post heart transplant , donor or recipient
, presence of specific antibodies pre transplant, chest tube, the presence of
ventricular assist devices before transplant, the use Extracorporeal membrane
oxygenation (ECMO), Implantable cardioverter defibrillator(ICD) ,the use of immunosuppressive
medication , blood transfusion or total parenteral nutrition (TPN), lipid
infusion, length of hospitalization, duration of central line use, and sit of
Therefore, we are conducting this study to assess risk
factors of CLABSI in post heart transplant patient in our institute.