EARLY CATHETER REMOVAL PROTOCOL AND DIURETIC USE IN SURGICAL INTENSIVE CARE PATIENTS 

Author(s):
Sami Majdalany; Kaitlyn Dobesh; Jay Getzinger; Zaina Khoury; Austin Mueller; Dhruva Kadiyala; Kristina Barrientos; Ali Dabaja; Loay Kabbani; Arielle Hodari Gupta

Background:

Highest reported healthcare-acquired infections are catheter associated urinary tract infections (CAUTIs) – associated with increased morbidity, mortality, and costs. Early Foley catheter removal reduces CAUTIs however, urinary retention (UR) is observed. Untreated UR leads to structural changes within the bladder smooth muscle, effecting muscle recovery. Scant data has investigated this phenomenon. 

 Our aim is to investigate diuretic use in Surgical Intensive Care Unit patients undergoing Urinary Catheter Alleviation Navigator Protocol (UCanP)/ CAUTI protocol (CAUTIp), and its relationship between time to spontaneous voiding and number of catheter reinsertions.  

Hypothesis:

We hypothesize that use of diuretics in patients undergoing UCanP/CAUTIp would lead to higher rates of catheter reinsertions and increased time to spontaneous voiding after catheter removal.  

Methods:

We conducted a retrospective chart review of CAUTIp patients between 2019-2020 at a single institution. Data included CAUTIp patients receiving diuretics after catheter discontinuation. Inclusion criteria contained SICU patients receiving indwelling catheterization undergoing CAUTIp. 

Results:

A total of 112 patients were included in the study of which 57 received diuretics (51%). Mean days of catheterization was 4 (range: 0-37), and mean days until void after removal was 0.21 (0-4). A significant difference was observed between catheter placement and days until spontaneous voiding. Mean quantity of diuretics was 125mL (0-2620). There was a significance bewteen groups for time until spontaneous voiding (p <0.05). However, multivariate regression investigating the length of time catheterized, mean days until voiding, mean diuretic use, mean post-void residual upon foley removal, and mean patient BMI showed no significant difference, p-value = 0.61 and R2 = 0.02. 

Conclusions:

Our review demonstrated time spent catheterized and diuretic use may contribute to time until spontaneous voiding upon catheter removal. Future studies will involve a larger sample size to query the entirety of our early catheter removal protocol.