Central venous catheter infections: concepts and controversies

Intensive Care Medicine
C R ReedB A Phelan

Abstract

Central venous catheters (CVCs) are widely used in critically ill patients in intensive care units. However, infectious complications are common and may limit their utility. We critically review the literature to determine the impact of CVC design and composition, insertion site selection, insertion procedures, care and removal of temporary CVCs on infectious complications. Relevant articles were identified and selected for review using a database search (Medline and manual of the English language literature) based upon study design and sample size with an emphasis on prospective randomized trials. To minimize infectious complications and maintain a reasonable cost-benefit ratio, we recommend: i) use a single lumen catheter unless clear indications for a multi-lumen catheter exist; ii) insert the catheter via the subclavian vein if no relative contraindication exists (bleeding diathesis, positive pressure ventilation); iii) disinfect the insertion site employing sterile technique; iv) apply a dry, sterile dressing and change the dressing every other day; v) inspect the insertion site for signs of infection and remove the catheter if pus is present; vi) if a catheter-related infection is suspected, change the catheter over a gui...Continue Reading

References

Aug 1, 1979·Annals of Internal Medicine·J D Band, D G Maki
Jun 9, 1977·The New England Journal of Medicine·D G MakiH W Sarafin
Mar 1, 1979·Anesthesia and Analgesia·G E Dryden, J Brickler
Dec 1, 1977·Archives of Surgery·R M StillmanP N Sawyer
Aug 23, 1976·JAMA : the Journal of the American Medical Association·R A WeinsteinL Corey
Dec 1, 1992·Journal of Cardiothoracic and Vascular Anesthesia·A BachH K Geiss
Oct 8, 1992·The New England Journal of Medicine·D K CobbB M Farr
Apr 15, 1992·JAMA : the Journal of the American Medical Association·K K HoffmannW A Rutala
May 8, 1991·JAMA : the Journal of the American Medical Association·G D KamalP J Jebson
Jul 1, 1990·Archives of Internal Medicine·E CercenadoE Bouza
May 1, 1987·JPEN. Journal of Parenteral and Enteral Nutrition·M C McCarthyT A Broadie
Feb 1, 1988·Revue de l'infirmière·Y Domart
Nov 1, 1988·Annals of Surgery·R H SnyderC J McDermott
Feb 1, 1988·The Surgical Clinics of North America·A A Hampton, R J Sherertz
Jan 1, 1988·Intensive Care Medicine·P CollignonP Woods
Apr 1, 1988·British Journal of Hospital Medicine·A J Coe, D P Coates
May 1, 1987·Archives of Internal Medicine·C Brun-BuissonM Rapin
Mar 1, 1987·Infection Control : IC·D R SnydmanW J Martin
Jan 1, 1987·Critical Care Medicine·J A Hudson-CivettaT A Hoffman
Jan 10, 1985·The New England Journal of Medicine·K H FalchukB J McNeil
May 1, 1985·JPEN. Journal of Parenteral and Enteral Nutrition·A Sitges-SerraL Lorente
May 1, 1985·JPEN. Journal of Parenteral and Enteral Nutrition·K A KudskR L Ruberg
Sep 1, 1985·Critical Care Medicine·W Samsoondar, J B Freeman
Apr 1, 1971·Archives of Surgery·V L HoshalP A Hoskins

❮ Previous
Next ❯

Citations

Jan 16, 2007·Langenbeck's Archives of Surgery·Eduardo E Montalvo-JaveMichael G Sarr
Aug 26, 1999·Seminars in Oncology Nursing·B K Shelton
Jun 29, 2000·Journal of the American College of Surgeons·S J PelletierR G Sawyer
Jul 20, 1999·Kidney International·S J Schwab, G Beathard
Jul 9, 1999·Critical Care Medicine·H M Grubbauer
Jun 12, 2003·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·J Casado-FloresA Valdivielso
Nov 16, 2004·Critical Care Medicine·Jonathan CohenJames Jorgensen
Apr 29, 2005·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·Rogier C J de JongeReinoud J B J Gemke
Nov 13, 2008·Seminars in Dialysis·Gerald A Beathard, Aris Urbanes
Sep 15, 2007·Medicinski pregled·Ljubica ArsenijevićAleksandar Karamarković
Feb 11, 2014·Journal of Infection and Chemotherapy : Official Journal of the Japan Society of Chemotherapy·Zied HajjejMustapha Ferjani
Jun 1, 1996·Intensive Care Medicine·A Bach
Nov 21, 1998·Chest·F Martinón-TorresJ M Martinón-Sánchez
Aug 26, 1998·Australian Critical Care : Official Journal of the Confederation of Australian Critical Care Nurses·B Roberts, D Cheung
Mar 30, 2001·Australian Critical Care : Official Journal of the Confederation of Australian Critical Care Nurses·K A Larwood
Nov 18, 2003·Anaesthesia·C G T Morris, E McCoy
Jun 6, 2002·Clinical Microbiology and Infection : the Official Publication of the European Society of Clinical Microbiology and Infectious Diseases·W GraningerM Ramharter
Nov 18, 2000·Infection Control and Hospital Epidemiology : the Official Journal of the Society of Hospital Epidemiologists of America·C Fariñas-AlvarezM Delgado-Rodríguez
Sep 1, 1996·European Journal of Anaesthesiology·A Michalopoulos, S Geroulanos
Dec 9, 2014·Biomedical Papers of the Medical Faculty of the University Palacký, Olomouc, Czechoslovakia·Ondrej MachotkaJiri Vlcek
Jul 9, 1999·Hospital Medicine·J I Vrazas
Jul 1, 1996·Intensive Care Medicine·F Kapadia, C Rodrigues
Oct 3, 2002·Current Opinion in Critical Care·Rondall K Lane, Michael A Matthay
May 5, 2000·The Cochrane Database of Systematic Reviews·K J Barrington
Nov 13, 2004·The Journal of Antimicrobial Chemotherapy·Nedim YücelEdmund A M Neugebauer
Jan 1, 2000·Hemodialysis International·Stephen R AshTodd S Ing
Nov 30, 2000·Anaesthesia and Intensive Care·D J FraenkelJ Lipman
Apr 23, 1999·Anaesthesia and Intensive Care·S McKinleyJ Penfold
May 8, 1999·Journal of the American Society of Nephrology : JASN·G A Beathard

❮ Previous
Next ❯

Related Concepts

Related Feeds

Blood Clotting Disorders

Thrombophilia includes conditions with increased tendency for excessive blood clotting. Blood clotting occurs when the body has insufficient amounts of specialized proteins that make blood clot and stop bleeding. Here is the latest research on blood clotting disorders.