Cessation of In-line Filters in Central Venous Catheters Does Not Significantly Influence the Incidence of Bloodstream Infections and Mortality in a Hospital Hematological Ward

Abstract

Objective The use of intravenous in-line filters is effective for the mechanical removal of large particles, precipitates, bacteria, fungi, large lipid globules, and air. However, the routine use of in-line filters remains controversial. Many patients with hematological diseases frequently suffer from bloodstream infections (BSIs) with fatal outcomes. Methods The year before cessation of an in-line filter was defined as the "filter period" and the year after its cessation was defined as the "non-filter period." The number of central line-associated bloodstream infections (CLABSIs), which are defined through surveillance, the catheter utilization rate, the number of patient deaths within 7 days after removal of the central venous catheters (CVCs), and the overall survival rate following CVC insertion were measured. Results During both periods, 84 patients had a total of 140 CVCs with a total number of catheter days of 3,407. There were 10 CVCs with CLABSIs, and the overall CLABSI rate was 2.9/1,000 catheter days, including 4 CVCs with CLABSIs (2.5/1,000 catheter days) during the filter period and 6 CVCs with CLABSIs (3.3/1,000 catheter days) during the non-filter period. The CLABSI rate, catheter utilization rate, and mortality did not differ significantly between the two periods. The only independent variable that was found to be significantly associated with the development of CLABSIs was a neutrophil count of <500×10 6 /L (p<0.05). Conclusion Our study revealed that the cessation of in-line filters from CVCs does not significantly influence the incidence of BSIs and mortality in patients with hematological disease. To confirm our results, however, a large-scale randomized controlled study is warranted.

Management of Y-Site Incompatibility of Intravenous Medication: A Systematic Review

“…Some studies showed a benefit, and others could not prove the significance of filter use. Two systematic reviews, one observational study, and one clinical trial have failed to prove the effectiveness of filters significantly in reducing complications, and also doubt the value of the filter (Foster et al, 2015;Niël-Weise et al, 2010;Tanaka et al, 2016;Virlouvet et al, 2020). However, some studies have been performed under ideal conditions, considered well-controlled and compliant to protocols so the incompatibilities were not identified.…”

The Use of 0.2 Micron Filter for All Intravenous Fluids in Sheikh Khalifa Medical City Paediatric Intensive Care Unit Practice Change Project

“…Duration of Project Trail 2 months in PICU, with continuous feedback from the end users and other health care providers [1][2][3][4][5][6].…”

Use of Intravenous Lipid Emulsions With Parenteral Nutrition: Practical Handling Aspects

“…63 For instance, in-line filters did not significantly influence the incidence of bloodstream infections, phlebitis, morbidity, and mortality. [64][65][66] Nevertheless, according to most national recommendations in Europe, there is a role for the use of in-line filtration of TNA for patients who require intensive parenteral therapy; the immunocompromised, neonates, and children might have increased susceptibility to the detrimental effects of particulate contamination and therefore can benefit from the use of filters during the administration of PN. 31,33,[67][68][69] In such cases, 0.22-μm filters should be used for lipid-free admixtures and 1.2-μm filters for lipidcontaining admixtures.…”