Use of Maximal Sterile Barrier Precautions and/or Antimicrobial-Coated Catheters to Reduce the Risk of Central Venous Catheter-Related Bloodstream Infection

Lee, Duk-hee; Jung, Koo Young; Choi, Yoon Hee

doi:10.1086/590356

Cited by 29 publications

(15 citation statements)

References 12 publications

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“…Therefore, to maintain a long-duration CP, we should consider factors such as expected prolonged neutropenia or age and the need for more careful nursing, especially for needling. Further study is warranted for preventive strategies such as skin antisepsis, maximum sterile barriers, use of antimicrobial catheters, and antimicrobial catheter lock solutions (16, 17). …”

Section: Discussionmentioning

confidence: 99%

Safety and Effectiveness of Central Venous Catheterization in Patients with Cancer: Prospective Observational Study

et al. 2010

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This study investigated the safety and effectiveness of each type of central venous catheters (CVC) in patients with cancer. We prospectively enrolled patients with cancer who underwent catherization involving a subclavian venous catheter (SVC), peripherally inserted central venous catheter (PICC), or chemo-port (CP) in our department. From March 2007 to March 2009, 116 patients underwent 179 episodes of catherization. A SVC was inserted most frequently (46.4%). Fifty-four complications occurred (30.1%): infection in 23 cases, malpositioning or migration of the tip in 18 cases, thrombosis in eight cases, and bleeding in five cases. Malpositioning or migration of the tip occurred more frequently with a PICC (P<0.001); infection occurred more often with a tunneled catheter (P=0.028) and was observed more often in young patients (P=0.023). The catheter life span was longer for patients with solid cancer (P=0.002) than for those with hematologic cancer, with a CP (P<0.001) than a PICC or SVC, and for an indwelling catheter with image guidance (P=0.014) than a blind procedure. In conclusion, CP is an effective tool for long term use and the fixation of tip is important for the management of PICC.

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Section: Discussionmentioning

confidence: 99%

Safety and Effectiveness of Central Venous Catheterization in Patients with Cancer: Prospective Observational Study

et al. 2010

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“…Use of maximal sterile barrier precautions during CVC insertion has been shown to reduce the incidence of CLABSIs compared to standard precautions. 26,79,[82][83][84] Third, catheters containing antimicrobial agents may be considered for hospital units with higher CLABSI rates than institutional goals, despite a comprehensive preventive strategy, and may be considered in specific patient populations at high risk of severe complications from a CLABSI. 11,69,80 Finally, providers should use a standardized procedure set-up when inserting CVCs to reduce the risk of CLABSIs.…”

Section: Rationalementioning

confidence: 99%

Recommendations on the Use of Ultrasound Guidance for Central and Peripheral Vascular Access in Adults: A Position Statement of the Society of Hospital Medicine

Franco‐Sadud

Schnobrich

Mathews

et al. 2019

Journal of Hospital Medicine

153

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PREPROCEDURE 1) We recommend that providers should be familiar with the operation of their specific ultrasound machine prior to initiation of a vascular access procedure.2) We recommend that providers should use a highfrequency linear transducer with a sterile sheath and sterile gel to perform vascular access procedures.3) We recommend that providers should use twodimensional ultrasound to evaluate for anatomical variations and absence of vascular thrombosis during preprocedural site selection. 4)We recommend that providers should evaluate the target blood vessel size and depth during preprocedural ultrasound evaluation. TECHNIQUES General Techniques 5)We recommend that providers should avoid using static ultrasound alone to mark the needle insertion site for vascular access procedures. 6)We recommend that providers should use real-time (dynamic), two-dimensional ultrasound guidance with a high-frequency linear transducer for central venous catheter (CVC) insertion, regardless of the provider's level of experience. 7)We suggest using either a transverse (short-axis) or longitudinal (long-axis) approach when performing realtime ultrasound-guided vascular access procedures. 8)We recommend that providers should visualize the needle tip and guidewire in the target vein prior to vessel dilatation. 9) To increase the success rate of ultrasound-guided vascular access procedures, we recommend that providers should utilize echogenic needles, plastic needle guides, and/or ultrasound beam steering when available. Central Venous Access Techniques 10)We recommend that providers should use a standardized procedure checklist that includes the use of real-time ultrasound guidance to reduce the risk of central line-associated bloodstream infection (CLABSI) from CVC insertion. 11)We recommend that providers should use real-time ultrasound guidance, combined with aseptic technique and maximal sterile barrier precautions, to reduce the incidence of infectious complications from CVC insertion. 12)We recommend that providers should use realtime ultrasound guidance for internal jugular vein catheterization, which reduces the risk of mechanical and infectious complications, the number of needle passes, and time to cannulation and increases overall procedure success rates. 13)We recommend that providers who routinely insert subclavian vein CVCs should use real-time ultrasound guidance, which has been shown to reduce the risk of mechanical complications and number of needle passes and increase overall procedure success rates compared with landmark-based techniques. 14)We recommend that providers should use real-time ultrasound guidance for femoral venous access, which has been shown to reduce the risk of arterial punctures and total procedure time and increase overall procedure success rates. Peripheral Venous Access Techniques 15)We recommend that providers should use real-time ultrasound guidance for the insertion of peripherally inserted central catheters (PICCs), which is associated with

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“…6 In addition, the relative risk of CRBSI in ICU2 was 0 after interventions, and the infection rates sustained 0 per 1000 catheter-days for 6 months in ICU2. We believe our modified standard procedure of CVC implantation could reduce the rates of CRBSI.…”

Section: Discussionmentioning

confidence: 96%

“…6 In addition, several large-scale studies support the observation that evidence-based interventions can reduce the rate of CRBSI. 1,7,8 The strategies for prevention of CRBSI include hand washing, using full-barrier precautions, cleaning the skin with chlorhexidine, catheter site selection (avoiding the femoral site), and removing unnecessary catheters.…”

Section: Introductionmentioning

confidence: 90%

Decreasing catheter-related bloodstream infections in the intensive care unit: Interventions in a medical center in central Taiwan

Liu

Chang

et al. 2012

Journal of Microbiology, Immunology and Infection

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Use of Maximal Sterile Barrier Precautions and/or Antimicrobial-Coated Catheters to Reduce the Risk of Central Venous Catheter-Related Bloodstream Infection

Cited by 29 publications

References 12 publications

Safety and Effectiveness of Central Venous Catheterization in Patients with Cancer: Prospective Observational Study

Safety and Effectiveness of Central Venous Catheterization in Patients with Cancer: Prospective Observational Study

Recommendations on the Use of Ultrasound Guidance for Central and Peripheral Vascular Access in Adults: A Position Statement of the Society of Hospital Medicine

Decreasing catheter-related bloodstream infections in the intensive care unit: Interventions in a medical center in central Taiwan

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