Low Infection Rate and Long Durability of Nontunneled Silastic Catheters

Abstract

Given the low infection rate and long durability of nontunneled silicone CVCs, these catheters could offer a cost-effective and safe alternative to surgically implantable tunneled catheters.

Diagnosis of vascular catheter-related bloodstream infection: a meta-analysis

“…The cost for measurement of serum vancomycin concentrations was not included because of recent data suggesting that monitoring these levels increases the cost of care without improving safety or efficacy (12). For the purpose of making this calculation, the costs of a replacement, nontunneled central venous catheter ($88), chest radiograph ($71), and coagulation studies ($47) were included for every patient having catheter segment cultures for diagnosis and for 10% of patients with blood cultures drawn from the catheter (69). No costs were added for infectious complications related to false negative tests or to delay in catheter removal because of blood cultures being drawn through the catheter, as it was assumed that such complications probably occur in less than 0.1% of febrile episodes in catheterized patients.…”

Low risk of central venous thrombosis with nontunnelled central venous catheters

“…Although the recent BCSH guidelines on the insertion and management of CVCs opted not to discuss the use of nontunnelled central lines (BCSH, 1997), a number of groups, routinely using these devices, have described favourable outcomes in terms of convenience, low incidence of infection and cost‐effectiveness (Cairoli et al., 1993; Raad et al., 1993; Gallardo et al., 1995; Camera et al., 1996). In a study directly comparing double lumen, nontunnelled subclavian CVCs to double lumen tunnelled devices inserted into the cephalic or external jugular vein, the nontunnelled CVCs caused significantly less bleeding at insertion and less exit site infection and septicaemia (Ahmed & Mohyuddin, 1998).…”

“…In a study directly comparing double lumen, nontunnelled subclavian CVCs to double lumen tunnelled devices inserted into the cephalic or external jugular vein, the nontunnelled CVCs caused significantly less bleeding at insertion and less exit site infection and septicaemia (Ahmed & Mohyuddin, 1998). In addition, nontunnelled CVCs allow the option, if catheter‐related sepsis is excluded, of CVC replacement over a guidewire instead of reinsertion at a different site (Raad et al., 1993; Camera et al., 1996).…”

Clinician's Perspective on Indwelling Central Venous Access Devices

“…However, nontunneled silastic catheters have been used successfuly at a single institution for all patients undergoing chemotherapy. 28 This patient group included patients undergoing prolonged periods of neutropenia and immunosuppression including leukemia and BMT patients. Acute leukemia patients were the only patient group with a risk for increased infection.…”