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Urologic studies suggest that urinary catheter dependent loops (tubing low points) may be a contributing cause of bacteriuria and urinary tract infection among catheterized patients. The means by which this type of contaminant transmission occurs, however, remains poorly understood. An observational, crosssectional study was conducted to provide a foundational look at catheter dependent loops and their possible role in catheter-acquired urinary tract infections, and as a building block for further research.
Key Words: Catheter-associated urinary tract infection (CAUTI), bacteriuria, indwelling catheter, dependent loop, air lock, intraluminal transmission, urinary retention, Froude number, Eotvos number.
Research Summary
Introduction
Urologic studies suggest that urinary catheter dependent loops (tubing low points) may be a contributing cause of bacteriuria and urinary tract infection (UTI) among catheterized patients. The means by which this type of contaminant transmission occurs, however, remains poorly understood. This study sought to investigate the nature of catheter tubingdependent loops and the prevalence of pressurized tubing, which is known to impede urine flow from the patient bladder.
Objective
To determine the prevalence and nature of indwelling catheter dependent loops within an inpatient hospital setting.
Methods
An observational, cross-sectional study was conducted in which measurements were taken of indwelling cathetertubing arrangements for consenting patients. The study was conducted along with recurring nursing compliance audits on two specific days.
Results
Data were collected on 55 patients of the 78 patients with urinary catheters at the time of audit. Tubing with a dependent loop was found in 87.3% of cases. Of these dependent loops, 28 cases (58.3%) existed with a stable positive pressure in the tubing directly distal to the patient (Type 1 dependent loop), and 14 cases (29.2%) were of Type 2 nature. Four cases (8.3%) showed no pressure differential at the time of examination. Two cases (4.2%) showed unstable urine within the tubing. Evaluation of the Type 1 dependent loops suggested that 9 cases displayed a "potential air-lock" condition, and 3 cases displayed a "probable air-lock". Of the Type 2 configuration of dependent loops, 14 cases indicated a "probable air-lock" condition.
Conclusions
Despite manufacturer literature and hospital teaching, dependent loops in indwelling catheter tubing are quite prevalent in the acute care setting as evidenced by this study. Dependent loops may contribute to difficulties with adequately draining urine and...