Skip to content
DraconiticResearch
Search Sources API
203,952 studies31 sourcesUpdated just now
Peer-reviewedCC BY 4.0Artificial Organs

Prevention and Management of Driveline Infections in Ventricular Assist Device Patients: The DESTINE 2.0 Staging Proposal and Expert Recommendations

  • Alexander M. Bernhardt1
  • Volker Lauenroth2
  • Florian Mueller3
  • Friedrich Kaufmann4
  • Katharina Homann5
  • Martina Socha6
  • Thomas Schlöglhofer6
  • the Driveline Expert STagINg and carE (DESTINE) study group
6 affiliations
  1. 1Department of Cardiac Surgery, University Heart and Vascular Center Hamburg University Hospital Hamburg‐Eppendorf Hamburg Germany
  2. 2Department for Thoracic‐ and Cardiovascular Surgery Heart & Diabetes Center, North Rhine‐Westphalia Bad Oeynhausen Germany
  3. 3Klinik für Innere Medizin III (Kardiologie, Angiologie Und Internistische Intensivmedizin), Universitätsklinikum Des Saarlandes Saarland University Homburg Germany
  4. 4Department of Cardiothoracic and Vascular Surgery Deutsches Herzzentrum der Charite Berlin Germany
  5. 5Department of Cardiothoracic, Transplantation and Vascular Surgery Hannover Medical School Hannover Germany
  6. 6Center for Medical Physics and Biomedical Engineering, Department of Cardiac and Thoracic Aortic Surgery Medical University of Vienna Vienna Austria
Read full textPDFDOICite

Abstract

Background: Driveline infections (DLIs) remain the predominant device‐specific complication in patients supported by left ventricular assist devices (LVADs) serving as a major source of morbidity, recurrent hospitalization, and mortality. Despite their clinical impact, the prevention and early management of DLIs lack standardization, particularly within outpatient and home‐based care environments.

Methods and Objectives: The original 2020 DESTINE proposal introduced a standardized dressing protocol and a prevention‐oriented staging system for driveline exit‐site management. However, subsequent clinical real‐world experience revealed limitations, including overly complex early‐stage subcategorization and the absence of contemporary guidance on wound care, including fixation strategies, antiseptic agents, and adjunctive therapies.

Updated Recommendations: DESTINE 2.0 provides expert recommendations to address these gaps. The updated framework features a streamlined five‐stage system that consolidates previous subcategories into unambiguous, actionable clinical stages. Enhanced recommendations are provided for driveline immobilization, stage‐stratified antiseptic agent selection, and skin barrier preservation. Furthermore, the protocol incorporates adjunctive therapies including cold atmospheric plasma and closed‐incision negative pressure wound therapy. Expanded guidance covers modifiable patient‐level risk factors, perioperative prophylaxis, showering safety, caregiver education, digital documentation, and stage‐directed antibiotic therapy.

Conclusion: By providing a practical, integrated framework applicable to multidisciplinary care settings, DESTINE 2.0 aims to optimize infection‐free survival, minimize healthcare utilization, and improve quality of life for patients on long‐term mechanical circulatory support.

Related

  1. Efficacy of Antimicrobial Silver‐Plated Dressings Compared to Usual Care in Preventing Left Ventricular Assist Device Driveline Infections
    Barbara Veiter, Martina Socha, Christiane Marko +7
    Artificial OrgansPeer-reviewedCC BY-NC 4.0Full textPMC
  2. AFSSAPS recommendations for the management of urinary tract infections in children
    L Barbeau, C Renoux, H Barbeau +2
    Exercer. La revue francophone de médecine généralePeer-reviewedPublisher termsFull textEcologyEpidemiology & public healthHAL
  3. TORCH-Related Maternal Infections in a Tertiary Referral Center: Diagnostic Pathways and Prenatal Management in the Context of Canadian and European Recommendations
    Claudia Colomba, Nicola Serra, Costanza Giordano +2
    Pathogens (Basel, Switzerland)Peer-reviewedCC BYFull textEurope PMC
  4. ECCO Guidelines on the Prevention, Diagnosis, and Management of Infections in Inflammatory Bowel Disease
    Henit A. Yanai, Pierre Ellul, Bram Verstockt +21
    Journal of Crohn s and ColitisPeer-reviewedLicence not statedFull text12 citedGenetics & genomicsGeneral medicineOpenAlex
  5. Malar Edema after Hyaluronic Acid Dermal Fillers: Expert Recommendations on Etiology, Prevention, and Management
    Wioletta Baranska‑Rybak, José V. Lajo‑Plaza, Lee Walker +1
    Dermatology and TherapyPeer-reviewedCC BY-NC 4.0Full textGeneral medicinePMCEurope PMCDOAJ

Cite

BibTeXRIS
BibTeX
@article{bernhardt2026prevention,
  title = {{Prevention and Management of Driveline Infections in Ventricular Assist Device Patients: The DESTINE 2.0 Staging Proposal and Expert Recommendations}},
  author = {Alexander M. Bernhardt and Volker Lauenroth and Florian Mueller and Friedrich Kaufmann and Katharina Homann and Martina Socha and Thomas Schlöglhofer and the Driveline Expert STagINg and carE (DESTINE) study group},
  journal = {Artificial Organs},
  year = {2026},
  month = sep,
  doi = {10.1111/aor.70237},
  url = {https://doi.org/10.1111/aor.70237},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Prevention and Management of Driveline Infections in Ventricular Assist Device Patients: The DESTINE 2.0 Staging Proposal and Expert Recommendations
AU  - Alexander M. Bernhardt
AU  - Volker Lauenroth
AU  - Florian Mueller
AU  - Friedrich Kaufmann
AU  - Katharina Homann
AU  - Martina Socha
AU  - Thomas Schlöglhofer
AU  - the Driveline Expert STagINg and carE (DESTINE) study group
PY  - 2026
DA  - 2026/09/09
JO  - Artificial Organs
DO  - 10.1111/aor.70237
UR  - https://doi.org/10.1111/aor.70237
AB  - Background: Driveline infections (DLIs) remain the predominant device‐specific complication in patients supported by left ventricular assist devices (LVADs) serving as a major source of morbidity, recurrent hospitalization, and mortality. Despite their clinical impact, the prevention and early management of DLIs lack standardization, particularly within outpatient and home‐based care environments.  Methods and Objectives: The original 2020 DESTINE proposal introduced a standardized dressing protocol and a prevention‐oriented staging system for driveline exit‐site management. However, subsequent clinical real‐world experience revealed limitations, including overly complex early‐stage subcategorization and the absence of contemporary guidance on wound care, including fixation strategies, antiseptic agents, and adjunctive therapies.  Updated Recommendations: DESTINE 2.0 provides expert recommendations to address these gaps. The updated framework features a streamlined five‐stage system that consolidates previous subcategories into unambiguous, actionable clinical stages. Enhanced recommendations are provided for driveline immobilization, stage‐stratified antiseptic agent selection, and skin barrier preservation. Furthermore, the protocol incorporates adjunctive therapies including cold atmospheric plasma and closed‐incision negative pressure wound therapy. Expanded guidance covers modifiable patient‐level risk factors, perioperative prophylaxis, showering safety, caregiver education, digital documentation, and stage‐directed antibiotic therapy.  Conclusion: By providing a practical, integrated framework applicable to multidisciplinary care settings, DESTINE 2.0 aims to optimize infection‐free survival, minimize healthcare utilization, and improve quality of life for patients on long‐term mechanical circulatory support.
SN  - 0160-564X
SN  - 1525-1594
ER  -