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PP208-SUN INTRALUMINAL AND EXTRALUMINAL CATHETER HUB CONTAMINATION IN PATIENTS WITH LONG-TERM CENTRAL VENOUS CATHETERS RECEIVING HOME PARENTERAL NUTRITION
Nutritional techniques and formulations identified by 6 (50%) patients. CRBSI was the most commonly missed with 4 (33%) patients not recognising signs, despite answering the question correctly, 2 patients (the lowest scoring) missing signs on 2 occasions. Conclusion: Although scores improved with time, it is not possible to say whether this was due to increased knowledge or the format of the questions. While patients correctly identified local infections and occlusion, CRBSI was not always recognised, even on subsequent presentations, suggesting the need for a validated assessment tool. Disclosure of Interest: None Declared
PP207-SUN EFFICACY AND SAFETY OF A NATURAL MINERAL WATER IN FEMALE CONSTIPATION: A RANDOMIZED DOUBLE BLIND PLACEBO CLINICAL TRIAL C. Dupont1 , G. Hebert2 , F. Constant3 , A. Campagne4 . 1 Hospital Necker, 2 SC Partners, Paris, 3 Nestl´ e Waters, Issy Les Moulineax, 4 Private Practice, Tours, France Rationale: H´ epar® , a natural mineral water rich in minerals, has long been considered efficient in constipation but its efficacy and tolerability have never been scientifically proven. Methods: A double blind placebo controlled trial was carried out in 244 females aged 18 60 y with constipation (Rome III criteria). Following a wash out period of 7 days with 1.5 2 L water intake, women were randomized to 3 groups with everyday consumption of 1.5 L of water, including 0.5 L H´ epar® ® (H´ epar0.5, n = 85), 1 L H´ epar (H´ epar1, n = 82) or exclusive low-mineral water (control, n = 77). Results: Compliance was good, 100.3(±11.2)%, with a mean daily consumption of 1.5±0.4 L and no serious adverse events. In the full analysis set population (n = 242), the main endpoint (diary self reported number of stools/week 4 or increasing by 2, and <25% lumpy to hard stools on Bristol scale) was achieved at 2 weeks (W2), control: 21.1%, H´ epar0.5: 30.9%, H´ epar1: 37.5% (p = 0.013). It was maintained at 4 weeks (W4), respectively 24.3%, 34.2% and 39% (p = 0.028). A magnesium sulphate linear dose-response was observed at W4, control (MgSO4 <1470 mOsm): 23.6% of responders, H´ epar0.5: 31.4%, H´ epar1 (MgSO4 >6751 mOsm): 45.2%. Patients with the higher level of abdominal pain (VisualAnalogScale) were the best responders at W2 and W4. Responders at W2 in the VAS >72 subgroup were in H´ epar1: 66.7% and in control: 25% (p = 0.039). H´ epar1 group needed significantly less salvage polyethylene glycol treatment from W2 (p = 0.034) to W4 (p = 0.001). Conclusion: In a trial respecting the good clinical practice (ICHE6), H´ epar® was an efficient treatment for constipation, acting from 1 L/day and from the second week. H´ epar® softened stools, was efficient in case of severe abdominal pain and reduced need for drug treatment. Safety was excellent. Disclosure of Interest: C. Dupont Grant/Research Support: honorarium, G. Hebert Grant/Research Support: honorarium, F. Constant Other: Nestl´ e Employee, A. Campagne Grant/Research Support: honorarium
S101 PP208-SUN INTRALUMINAL AND EXTRALUMINAL CATHETER HUB CONTAMINATION IN PATIENTS WITH LONG-TERM CENTRAL VENOUS CATHETERS RECEIVING HOME PARENTERAL NUTRITION M. Small1 , S. Gabe1 . 1 Clinical Nutrition, St Mark’s Hospital, Harrow, United Kingdom Rationale: Central venous catheter (CVC) hub contamination is associated with catheter related sepsis. This study aimed to evaluate the frequency of contamination and association with catheter sepsis to assess the role for hub swabs in determining and classifying infection, specifically catheter related bloodstream infection (CRBSI) and central line associated bloodstream infection (CLABSI). Methods: For 8 months all CVC removed from home parenteral nutrition patients were analysed. The intraluminal hub surface was sampled by inserting a swab and rotating, the extraluminal surface was sampled by swabbing across the external threads. CVC dwell time, previous CRBSI and reason for removal were recorded. For comparison 3 controls were included (1 new and 2 demonstration CVC, one deliberately contaminated). Results: 77 hubs and 3 controls were analysed. Median CVC dwell time 4.5 (0.25 121) months. 28 CVC (36%) were removed for infective and 49 (64%) for non-infective reasons. Positive hub swabs were found in 12 (15.6%) CVC (all removed due to CRBSI). The contaminated control hub was positive. Positive hub threads were only found in CVC with positive hubs, in 2 CVC (2.6%). All controls were negative. Of the 12 positive hubs the same organism was isolated from the hub and blood on 8 (67%) occasions. 3 positive swabs were from CVC with previous CRBSI, although none was with the same organism isolated from the hub. Conclusion: Positive hub swabs were found infrequently, and only where a diagnosis of CRBSI had been made, suggesting swabbing hubs as an aid to diagnosis or distinguishing between CRBSI and CLABSI is of limited value. CVC dwell time and previous CRBSI was not associated with a positive result. The small number of positive hub threads, including the contaminated control, could indicate failure of the sampling method warranting further validation studies. Disclosure of Interest: None Declared
PP209-SUN OMEGA-3 FATTY ACIDS-RICH SUPPLEMENT IMPROVES THE PERI-OPERATIVE IMMUNE RESPONSES AFTER CARDIAC SURGERY K. Nakamura1,2 , H. Iwase3 , H. Kariyazono2 , H. Yamamoto1 . 1 Cardiovascular and Gastroenterological Surgery, Advanced Therapeutics Cardiovascular and Respiratory Disorders, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, 2 Pharmacy, Nagasaki International University, Sasebo, 3 Biopharmaceutics, Nihon Pharmaceutical University, Kitaadachi-Gun, Japan Rationale: To investigate the effect of a dietary supplement enriched in omega-3 fatty acids on peri-operative immune responses in patients undergoing heart surgery. Methods: Patients in the supplement group (n = 7) received 1 L/day of Impact (Japan) for 5 days before surgery; those in the
PP207-SUN EFFICACY AND SAFETY OF A NATURAL MINERAL WATER IN FEMALE CONSTIPATION: A RANDOMIZED DOUBLE BLIND PLACEBO CLINICAL TRIAL C. Dupont1 , G. Hebert2 , F. Constant3 , A. Campagne4 . 1 Hospital Necker, 2 SC Partners, Paris, 3 Nestl´ e Waters, Issy Les Moulineax, 4 Private Practice, Tours, France Rationale: H´ epar® , a natural mineral water rich in minerals, has long been considered efficient in constipation but its efficacy and tolerability have never been scientifically proven. Methods: A double blind placebo controlled trial was carried out in 244 females aged 18 60 y with constipation (Rome III criteria). Following a wash out period of 7 days with 1.5 2 L water intake, women were randomized to 3 groups with everyday consumption of 1.5 L of water, including 0.5 L H´ epar® ® (H´ epar0.5, n = 85), 1 L H´ epar (H´ epar1, n = 82) or exclusive low-mineral water (control, n = 77). Results: Compliance was good, 100.3(±11.2)%, with a mean daily consumption of 1.5±0.4 L and no serious adverse events. In the full analysis set population (n = 242), the main endpoint (diary self reported number of stools/week 4 or increasing by 2, and <25% lumpy to hard stools on Bristol scale) was achieved at 2 weeks (W2), control: 21.1%, H´ epar0.5: 30.9%, H´ epar1: 37.5% (p = 0.013). It was maintained at 4 weeks (W4), respectively 24.3%, 34.2% and 39% (p = 0.028). A magnesium sulphate linear dose-response was observed at W4, control (MgSO4 <1470 mOsm): 23.6% of responders, H´ epar0.5: 31.4%, H´ epar1 (MgSO4 >6751 mOsm): 45.2%. Patients with the higher level of abdominal pain (VisualAnalogScale) were the best responders at W2 and W4. Responders at W2 in the VAS >72 subgroup were in H´ epar1: 66.7% and in control: 25% (p = 0.039). H´ epar1 group needed significantly less salvage polyethylene glycol treatment from W2 (p = 0.034) to W4 (p = 0.001). Conclusion: In a trial respecting the good clinical practice (ICHE6), H´ epar® was an efficient treatment for constipation, acting from 1 L/day and from the second week. H´ epar® softened stools, was efficient in case of severe abdominal pain and reduced need for drug treatment. Safety was excellent. Disclosure of Interest: C. Dupont Grant/Research Support: honorarium, G. Hebert Grant/Research Support: honorarium, F. Constant Other: Nestl´ e Employee, A. Campagne Grant/Research Support: honorarium
S101 PP208-SUN INTRALUMINAL AND EXTRALUMINAL CATHETER HUB CONTAMINATION IN PATIENTS WITH LONG-TERM CENTRAL VENOUS CATHETERS RECEIVING HOME PARENTERAL NUTRITION M. Small1 , S. Gabe1 . 1 Clinical Nutrition, St Mark’s Hospital, Harrow, United Kingdom Rationale: Central venous catheter (CVC) hub contamination is associated with catheter related sepsis. This study aimed to evaluate the frequency of contamination and association with catheter sepsis to assess the role for hub swabs in determining and classifying infection, specifically catheter related bloodstream infection (CRBSI) and central line associated bloodstream infection (CLABSI). Methods: For 8 months all CVC removed from home parenteral nutrition patients were analysed. The intraluminal hub surface was sampled by inserting a swab and rotating, the extraluminal surface was sampled by swabbing across the external threads. CVC dwell time, previous CRBSI and reason for removal were recorded. For comparison 3 controls were included (1 new and 2 demonstration CVC, one deliberately contaminated). Results: 77 hubs and 3 controls were analysed. Median CVC dwell time 4.5 (0.25 121) months. 28 CVC (36%) were removed for infective and 49 (64%) for non-infective reasons. Positive hub swabs were found in 12 (15.6%) CVC (all removed due to CRBSI). The contaminated control hub was positive. Positive hub threads were only found in CVC with positive hubs, in 2 CVC (2.6%). All controls were negative. Of the 12 positive hubs the same organism was isolated from the hub and blood on 8 (67%) occasions. 3 positive swabs were from CVC with previous CRBSI, although none was with the same organism isolated from the hub. Conclusion: Positive hub swabs were found infrequently, and only where a diagnosis of CRBSI had been made, suggesting swabbing hubs as an aid to diagnosis or distinguishing between CRBSI and CLABSI is of limited value. CVC dwell time and previous CRBSI was not associated with a positive result. The small number of positive hub threads, including the contaminated control, could indicate failure of the sampling method warranting further validation studies. Disclosure of Interest: None Declared
PP209-SUN OMEGA-3 FATTY ACIDS-RICH SUPPLEMENT IMPROVES THE PERI-OPERATIVE IMMUNE RESPONSES AFTER CARDIAC SURGERY K. Nakamura1,2 , H. Iwase3 , H. Kariyazono2 , H. Yamamoto1 . 1 Cardiovascular and Gastroenterological Surgery, Advanced Therapeutics Cardiovascular and Respiratory Disorders, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, 2 Pharmacy, Nagasaki International University, Sasebo, 3 Biopharmaceutics, Nihon Pharmaceutical University, Kitaadachi-Gun, Japan Rationale: To investigate the effect of a dietary supplement enriched in omega-3 fatty acids on peri-operative immune responses in patients undergoing heart surgery. Methods: Patients in the supplement group (n = 7) received 1 L/day of Impact (Japan) for 5 days before surgery; those in the