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Vol. 151. Issue 8.
Pages 299-307 (October 2018)
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Vol. 151. Issue 8.
Pages 299-307 (October 2018)
Original article
DOI: 10.1016/j.medcli.2018.04.015
Impact of an ultraviolet air sterilizer on cardiac surgery patients, a randomized clinical trial
Impacto de un esterilizador ultravioleta en pacientes de cirugía cardíaca: ensayo clínico aleatorizado
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María Heredia-Rodrígueza,b, Elisa Álvarez-Fuentea,b, Juan Bustamante-Munguirac, Rodrigo Poves-Alvareza,b,
Corresponding author
rpoves@saludcastillayleon.es

Corresponding author.
, Inmaculada Fierrod, Esther Gómez-Sáncheza,b, Estefanía Gómez-Pesqueraa,b, Mario Lorenzo-Lópeza,b, José María Eirosf, Francisco Javier Álvareze, Eduardo Tamayoe,b
a Department of Anaesthesiology, Hospital Clínico Universitario, Valladolid, Spain
b BioCritic, Group for Biomedical Research in Critical Care Medicine, Valladolid, Spain
c Department of Cardiovascular Surgery, Hospital Universitario de La Princesa, Madrid, Spain
d Department of Health Sciences, European University Miguel de Cervantes, Valladolid, Spain
e Department of Pharmacology, University of Valladolid, Valladolid, Spain
f Department of Microbiology, Hospital Río Hortega, Valladolid, Spain
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Figures (2)
Tables (6)
Table 1. Characteristics of the patients at baseline.
Table 2. Analytical results at the time of admission to the ICU (1) and maximum peaks reached (2) in patients placed in the rooms with the UVAS and the control group without the UVAS.
Table 3. Description of microorganisms isolated from different sites of infection in patients placed in rooms with the ultraviolet air sterilizer (UVAS) (n=575) and the control group without the UVAS (n=522).
Table 4. Study outcomes.
Table 5. Demographic, clinical, and perioperative characteristics of survivor and non-survivor patients who underwent cardiac surgery and were admitted to the ICU.
Table 6. Analytical results at the time of admission to the ICU (1) and maximum peaks reached (2) in survivor and non-survivor patients.
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Abstract
Background

Numerous studies have evaluated the use of ultraviolet-C devices for terminal disinfection in hospitals, however, to date there is little information about the device's final impact on patients. We investigated the effect of an ultraviolet air sterilizer (UVAS) on the clinical outcomes of cardiac surgery patients.

Materials and methods

This random, prospective and non-interventional study included 1097 adult patients undergoing elective cardiac surgery: 522 stayed in an ICU room with UVAS (Medixair®) and 575 patients ICU room without UVAS and were used as a control. The primary outcome measure was to evaluate the effect of a UVAS on the overall prevalence of nosocomial infections in postoperative cardiac patients in ICUs.

Results

No significant differences in ventilator-associated pneumonia (4.6% vs. 5.0%, p=0.77) and total infection (14.0% vs. 15.5%, p=0.45) rates were detected in patients with and without the UVAS. The length of stay in the intensive care unit and at the hospital was similar in both groups, UVAS (4.6 (8.2) days and 18.3 (5.5) days) and without UVAS (4.6 (7.3) days and 19.2 (18.6) days). The 30-day in-hospital mortality rate was 5.3%, no significant differences between groups were observed (p=0.053).

Conclusion

Novel ultraviolet-C technology has not been shown to significantly reduce nosocomial infections or mortality rates in cardiac surgery patients.

Keywords:
Intensive care unit
Nosocomial infection
Outcomes
Sterilization
Ultraviolet
Resumen
Introducción

Numerosos estudios han evaluado el uso de dispositivos ultravioleta C para la desinfección terminal en hospitales; sin embargo, hasta la fecha existen pocos datos sobre el impacto en los pacientes. Hemos evaluado el efecto de un esterilizador de aire ultravioleta (UVAS) sobre las variables clínicas de los pacientes operados de cirugía cardíaca.

Materiales y métodos

Este estudio prospectivo, aleatorizado no intervencional incluyó 1.097 pacientes adultos intervenidos de cirugía cardíaca electiva: 522 ingresaron en una habitación de UCI con UVAS (Medixair®) y 575 pacientes en habitación de UCI sin UVAS se utilizaron como control. La variable principal medida fue el efecto del UVAS sobre la prevalencia global de infecciones en el postoperatorio de cirugía cardíaca en UCI.

Resultados

No hubo diferencias significativas en la neumonía asociada a ventilación mecánica (4,6% vs. 5,0%, p=0,77) e índices totales de infección (14,0% vs. 15,5%, p=0,45) detectados en pacientes con y sin UVAS. La duración del ingreso en UCI y en el hospital fue similar en ambos grupos, UVAS (4,6 [8,2] días y 18,3 [5,5] días) y sin UVAS (4,6 [7,3] días y 19,2 [18,6] días). La mortalidad a 30 días hospitalaria fue del 5,3%, sin diferencias significativas entre los grupos (p=0,053).

Conclusión La nueva tecnología ultravioleta C no ha demostrado disminuir las infecciones nosocomiales ni la mortalidad en pacientes de cirugía cardíaca.

Palabras clave:
Unidad de Cuidados Intensivos
Infección nosocomial
Resultados, Esterilización
Ultravioleta

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