The catheters used were not antimicrobial-coated, but were radiopaque polyurethane catheters (Arrow, Reading, PA, USA). The study was approved by the institutional review board. The objective of this study was to analyze the incidence of CRLI and CRBSI at each central venous site.Ī 3-year prospective study was performed that included all patients admitted to the 24-bed intensive care unit (ICU) of the Hospital Universitario de Canarias (Tenerife), between and 30 April 2003.
In the study presented here, we have increased the number of CVCs due to the probability of finding another significant difference.Īlthough there are many studies about CVC-related infection, we have found only two studies that have analyzed it in detail, but the number of CVCs used, 300 and 499 respectively, were lower than the 2,595 in our study. The incidence density of CRLI in femoral or jugular sites was significantly higher than in the subclavian site apart from this, there were no other significant differences between the use of CVCs at different sites. In a previous study, our team analyzed catheter-related local infection (CRLI) and catheter-related bloodstream infection (CRBSI) resulting from the use of CVCs these were reported for each site of CVC placement. Interest in catheter-related infection lies in the mortality and the costs it represents. Ĭentral venous catheterization may cause different complications, including infection, haemorrhage and thrombosis. The use of catheters is habitual in critically ill patients in the EPIC study, 78% of critically ill patients had some form of CVC inserted.
Our results suggest that the order for punction, to minimize the CVC-related infection risk, should be subclavian (first order), jugular (second order) and femoral vein (third order).Ĭentral venous catheters (CVCs) are commonly used in critically ill patients for the administration of fluids, medications, blood products and parenteral nutrition, for the insertion of a transvenous pacing electrode and to monitor hemodynamic status. CRBSI incidence density was statistically higher for femoral than for jugular (8.34 versus 2.99, p = 0.002) and subclavian (8.34 versus 0.97, p < 0.001) accesses, and higher for jugular than for subclavian access (2.99 versus 0.97, p = 0.005). CRLI incidence density was statistically higher for femoral than for jugular (15.83 versus 7.65, p < 0.001) and subclavian (15.83 versus 1.57, p < 0.001) accesses, and higher for jugular than for subclavian access (7.65 versus 1.57, p < 0.001). The number of CVCs and days of catheterization duration were: global, 2,595 and 18,999 subclavian, 917 and 8,239 jugular, 1,390 and 8,361 femoral, 288 and 2,399. All consecutive patients admitted to the ICU during 3 years ( and 30 April 2003) were included. This is a prospective and observational study, conducted in a 24-bed medical surgical intensive care unit of a 650-bed university hospital. The objective of this study was to analyze the incidence of catheter-related local infection (CRLI) and catheter-related bloodstream infection (CRBSI) with central venous catheters (CVCs) according to different access sites. Although there are many studies about CVC-related infection, very few have analyzed it in detail.
Central venous catheterization is commonly used in critically ill patients and may cause different complications, including infection.
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