Routine changing of intravascular administration sets does not reduce colonisation or infection in central venous catheters
Rickard, Claire, Lipman, Jeff, Courtney, Mary D., Siversen, Rosemary, & Daley, Peter (2004) Routine changing of intravascular administration sets does not reduce colonisation or infection in central venous catheters. Infection Control and Hospital Epidemiology, 25(8), pp. 650-655.
Objective: To determine the effect of routine intravascular administration-set changes on central venous catheter (CVC) colonization and catheter related bacteremia (CRB).
Design: Prospective, randomised controlled trial
Setting: 18-bed ICU in a University-affiliated, tertiary referral hospital.
Participants: 404 chlorhexidine and silver sulfadiazine coated multi-lumen CVCs from 251 intensive care unit (ICU) patients.
Interventions: After ethical approval, CVCs inserted in ICU and in situ on Day 4 were randomised to have their administration-sets changed on Day 4 (n = 203) or not at all (n = 201). Fluid container and blood product administration-set use was limited to 24 hours. CVCs were removed (Day 7, not required or suspected infection), and cultured for colonization ( 15 cfu). Medical and laboratory staff were blinded. CRB was diagnosed by a blinded intensivist using strict definitions. Data was collected on; catheter life, CVC site, APACHE II score, patient age, diagnosis, hyperglycemia, hypoalbuminemia, immune status, number of fluid containers and intravenous injections, propofol, blood, TPN or lipid infusion.
Results: There were 10 colonized CVCs in the set change group and 19 in the no change group. This was not a statistically significant difference on Kaplan Meier survival analysis (Effect Size = 0.09, Log Rank = 0.87, df = 1, p = 0.35). There were 3 cases of CRB per group. Logistic regression found that burns diagnosis and increased ICU stay were the only factors that significantly predicted colonization (p < 0.001).
Conclusions: Intravenous administration-sets can be used for 7-days. Routine administration-set changes are unnecessary before this time.
Impact and interest:
Citation counts are sourced monthly from and citation databases.
These databases contain citations from different subsets of available publications and different time periods and thus the citation count from each is usually different. Some works are not in either database and no count is displayed. Scopus includes citations from articles published in 1996 onwards, and Web of Science® generally from 1980 onwards.
Citations counts from theindexing service can be viewed at the linked Google Scholar™ search.
Full-text downloads displays the total number of times this work’s files (e.g., a PDF) have been downloaded from QUT ePrints as well as the number of downloads in the previous 365 days. The count includes downloads for all files if a work has more than one.
|Item Type:||Journal Article|
|Keywords:||Intravascular administration, set, catheter colonization, catheter related bacteremia, intensive care, central venous catheter|
|Subjects:||Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > NURSING (111000) > Clinical Nursing - Secondary (Acute Care) (111003)|
|Divisions:||Current > QUT Faculties and Divisions > Faculty of Health
Current > Institutes > Institute of Health and Biomedical Innovation
|Copyright Owner:||Copyright 2004 The Society for Healthcare Epidemiology of America|
|Copyright Statement:||Reproduced in accordance with the copyright policy of the publisher.|
|Deposited On:||01 Jul 2005|
|Last Modified:||29 Feb 2012 13:07|
Repository Staff Only: item control page