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Reynolds H, Gowardman J, Woods C. Care bundles and peripheral arterial catheters. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2024; 33:S34-S41. [PMID: 38271041 DOI: 10.12968/bjon.2024.33.2.s34] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/27/2024]
Abstract
HIGHLIGHTS What we know about the topic: Recommendations for the use of vascular access care bundles to reduce infection are followed for different devices. The risk of arterial catheter-related infection is comparable with short-term, non-cuffed central venous catheters. There are practice concerns for clinicians inserting and caring for peripheral arterial catheters. What this paper adds: The selected studies had a theme of decreased infection after using bundled strategies for all devices. Few studies addressed use of bundles for care of peripheral arterial catheters. High-quality research should be performed about using care bundles for insertion and care of arterial catheters. INTRODUCTION A scoping review of the literature was performed. AIMS/OBJECTIVES To find information on the use of care bundles for care of arterial, central, and peripherally inserted venous catheters. METHODS Data was extracted by 2 independent researchers using standardized methodology. RESULTS Results of 84 studies included 2 (2.4%) randomized controlled trials, 38 (45.2%) observational studies, 29 (34.5%) quality projects, and 15 (17.9%) reviews. Populations had more adults than pediatric patients. All studies had the most prominent theme of decreased infection in all devices after using bundle strategies. DISCUSSION AND CONCLUSIONS The mapping of available evidence strongly supports the use of care bundles to reduce infection in the care of all intravascular devices. However, deficiencies regarding practice concerns about insertion and care of arterial catheters highlight areas for future research with the aim to eliminate the gap in the evidence of studies of care bundles for peripheral arterial catheters.
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Affiliation(s)
- Heather Reynolds
- Department of Anaesthesia & Perioperative Medicine, Royal Brisbane & Women's Hospital, Herston, Queensland, Australia, The University of Queensland, St Lucia, Queensland, Australia, Alliance for Vascular Access Teaching & Research, Griffith University, Nathan, Queensland, Australia
| | - John Gowardman
- Department of Intensive Care Medicine, Royal Brisbane & Women's Hospital, Herston, Queensland, Australia, The University of Queensland, St Lucia, Queensland, Australia
| | - Christine Woods
- Department of Anaesthesia & Perioperative Medicine, Royal Brisbane & Women's Hospital, Herston, Queensland, Australia, The University of Queensland, St Lucia, Queensland, Australia
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Böll B, Schalk E, Buchheidt D, Hasenkamp J, Kiehl M, Kiderlen TR, Kochanek M, Koldehoff M, Kostrewa P, Claßen AY, Mellinghoff SC, Metzner B, Penack O, Ruhnke M, Vehreschild MJGT, Weissinger F, Wolf HH, Karthaus M, Hentrich M. Central venous catheter-related infections in hematology and oncology: 2020 updated guidelines on diagnosis, management, and prevention by the Infectious Diseases Working Party (AGIHO) of the German Society of Hematology and Medical Oncology (DGHO). Ann Hematol 2021; 100:239-259. [PMID: 32997191 PMCID: PMC7782365 DOI: 10.1007/s00277-020-04286-x] [Citation(s) in RCA: 60] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Accepted: 09/23/2020] [Indexed: 12/31/2022]
Abstract
Cancer patients frequently require central venous catheters for therapy and parenteral nutrition and are at high risk of central venous catheter-related infections (CRIs). Moreover, CRIs prolong hospitalization, cause an excess in resource utilization and treatment cost, often delay anti-cancer treatment, and are associated with a significant increase in mortality in cancer patients. We therefore summoned a panel of experts by the Infectious Diseases Working Party (AGIHO) of the German Society of Hematology and Medical Oncology (DGHO) and updated our previous guideline on CRIs in cancer patients. After conducting systematic literature searches on PubMed, Medline, and Cochrane databases, video- and meeting-based consensus discussions were held. In the presented guideline, we summarize recommendations on definition, diagnosis, management, and prevention of CRIs in cancer patients including the grading of strength of recommendations and the respective levels of evidence. This guideline supports clinicians and researchers alike in the evidence-based decision-making in the management of CRIs in cancer patients.
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Affiliation(s)
- Boris Böll
- Department I of Internal Medicine, Hematology and Oncology, Intensive Care Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, University of Cologne, Kerpener Strasse 62, 50937, Cologne, Germany.
| | - Enrico Schalk
- Department of Hematology and Oncology, Otto-von-Guericke University Magdeburg, Medical Center, Magdeburg, Germany
| | - Dieter Buchheidt
- Department of Hematology and Oncology, Mannheim University Hospital, Heidelberg University, Mannheim, Germany
| | - Justin Hasenkamp
- Clinic for Hematology and Oncology, University Medicine Göttingen, Georg-August-University, Göttingen, Germany
| | - Michael Kiehl
- Department of Internal Medicine, Frankfurt (Oder) General Hospital, Frankfurt/Oder, Germany
| | - Til Ramon Kiderlen
- Department of Hematology, Oncology and Palliative Care, Vivantes Clinic Neukoelln, Berlin, Germany
| | - Matthias Kochanek
- Department I of Internal Medicine, Hematology and Oncology, Intensive Care Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, University of Cologne, Kerpener Strasse 62, 50937, Cologne, Germany
| | - Michael Koldehoff
- Department of Bone Marrow Transplantation, West German Cancer Center, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Philippe Kostrewa
- Department of Hematology and Oncology, Campus Fulda, Philipps-University Marburg, Fulda, Germany
| | - Annika Y Claßen
- Department I of Internal Medicine, Hematology and Oncology, Intensive Care Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, University of Cologne, Kerpener Strasse 62, 50937, Cologne, Germany
| | - Sibylle C Mellinghoff
- Department I of Internal Medicine, Hematology and Oncology, Intensive Care Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, University of Cologne, Kerpener Strasse 62, 50937, Cologne, Germany
| | - Bernd Metzner
- Department of Hematology and Oncology, University Hospital Oldenburg, Oldenburg, Germany
| | - Olaf Penack
- Department of Hematology, Oncology, and Tumor Immunology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Markus Ruhnke
- Department of Hematology and Oncology, Helios Klinikum Aue, Aue, Germany
| | - Maria J G T Vehreschild
- Department of Internal Medicine, Infectious Diseases, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Florian Weissinger
- Department of Hematology, Oncology and Palliative Care, Department of Internal Medicine, Evangelisches Klinikum Bethel, Bielefeld, Germany
| | - Hans-Heinrich Wolf
- Department III of Internal Medicine, Hematology, Oncology and Hemostaseology, Südharzklinikum, Nordhausen, Germany
| | - Meinolf Karthaus
- Department of Hematology, Oncology & Palliative Care, Klinikum Neuperlach, Munich, Germany
| | - Marcus Hentrich
- Department of Hematology and Oncology, Red Cross Hospital Munich, Munich, Germany
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3
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Reducing central vein catheterization complications with a focused educational program: a retrospective cohort study. Sci Rep 2020; 10:17530. [PMID: 33067489 PMCID: PMC7568571 DOI: 10.1038/s41598-020-74395-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Accepted: 08/24/2020] [Indexed: 01/29/2023] Open
Abstract
Central venous catheters (CVCs) are frequently used, but the rate of complications is high. This study evaluates the effects of a short training program for CVC insertion in a university-based teaching hospital. A sample of adults with CVCs inserted outside the intensive care unit was selected from two academic years: 2015, year without structured training, and 2016, year with structured training. Clinical and laboratory information, as well as the procedure’s characteristics and complications (mechanical and infectious) were collected. The incidence of complications before and after the training was compared. A total of 1502 punctures were evaluated. Comparing the pre- and post-training period, there was an increase in the choice for jugular veins and the use of ultrasound. A numerical reduction in the rate of complications was identified (RR 0.732; 95% CI 0.48–1.12; P = 0.166). This difference was driven by a statistically significant lower rate of catheter-related infections (RR 0.78; 95% CI 0.64–0.95; P = 0.047). In the multivariate analysis, aspects regarding technique (ultrasound use, multiple punctures) and year of training were associated with outcomes. Structured training reduces the rate of complications related to CVC insertion, especially regarding infections.
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Stocco JGD, Hoers H, Pott FS, Crozeta K, Barbosa DA, Meier MJ. Second-Generation central venous catheter in the prevention of bloodstream infection: a systematic review. Rev Lat Am Enfermagem 2017; 24:e2722. [PMID: 27508901 PMCID: PMC4990028 DOI: 10.1590/1518-8345.0756.2722] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2015] [Accepted: 12/13/2015] [Indexed: 12/02/2022] Open
Abstract
Objective: to evaluate the effectiveness and safety in the use of second-generation central
venous catheters impregnated in clorhexidine and silver sulfadiazine when compared
with other catheters, being them impregnated or not, in order to prevent the
bloodstream infection prevention. Method: systematic review with meta-analysis. Databases searched: MEDLINE, EMBASE,
CINAHL, LILACS/SciELO, Cochrane CENTRAL; search in Congress Proceedings and
records from Clinical Trials. Results: 1.235 studies were identified, 97 were pre-selected and 4 were included. In
catheter-related bloodstream infection, there was no statistical significance
between second-generation impregnated catheter compared with the non-impregnated
ones, absolute relative risk 1,5% confidence interval 95% (3%-1%), relative risk
0,68 (confidence interval 95%, 0,40-1,15) and number needed to treat 66. In the
sensitivity analysis, there was less bloodstream infection in impregnated
catheters (relative risk 0,50, confidence interval 95%, 0,26-0,96). Lower
colonization, absolute relative risk 9,6% (confidence interval 95%, 10% to 4%),
relative risk 0,51 (confidence interval 95% from 0,38-0,85) and number needed to
treat 5. Conclusion: the use of second-generation catheters was effective in reducing the catheter
colonization and infection when a sensitivity analysis is performed. Future
clinical trials are suggested to evaluate sepsis rates, mortality and adverse
effects.
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Affiliation(s)
| | - Hellen Hoers
- Doctoral Student, Departamento de Enfermagem, Universidade Federal do Paraná, Curitiba, PR, Brazil. Adjunct Professor, Departamento de Enfermagem, Universidade Federal do Paraná, Curitiba, PR, Brazil
| | - Franciele Soares Pott
- Doctoral Student, Universidade Federal do Paraná, Curitiba, PR, Brasil. RN, Secretaria Estadual de Segurança Pública, Curitiba, PR, Brazil
| | - Karla Crozeta
- PhD, Adjunct Professor, Departamento de Enfermagem, Universidade Federal do Paraná, Curitiba, PR, Brazil
| | - Dulce Aparecida Barbosa
- PhD, Associate Professor, Escola Paulista de Enfermagem, Universidade Federal de São Paulo, São Paulo, SP, Brazil. 7 PhD, Associate Professor, Departamento de Enfermagem, Universidade Federal do Paraná, Curitiba, PR, Brazil
| | - Marineli Joaquim Meier
- PhD, Associate Professor, Escola Paulista de Enfermagem, Universidade Federal de São Paulo, São Paulo, SP, Brazil. 7 PhD, Associate Professor, Departamento de Enfermagem, Universidade Federal do Paraná, Curitiba, PR, Brazil
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Karlnoski R, Abboud EC, Thompson P, Oxner AZ, Sinnott JT, Marcet JE. Reduction in Central Line-Associated Bloodstream Infections Correlated With the Introduction of a Novel Silver-Plated Dressing for Central Venous Catheters and Maintained for 6 Years. J Intensive Care Med 2017; 34:544-549. [PMID: 29216782 DOI: 10.1177/0885066617745034] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To assess a novel silver-plated dressing (SD) for central venous catheters in comparison to chlorhexidine gluconate-impregnated sponge (CHGIS) dressings in preventing central line-associated bloodstream infections (CLABSIs) in adult intensive care unit (ICU) patients. DESIGN Retrospective cohort study. SETTING Tampa General Hospital, an academic medical tertiary care center. PATIENTS All adult ICU patients of an academic medical tertiary care center from January 2009 to December 2010. MEASUREMENTS AND MAIN RESULTS A total of 3189 patient records were studied from 7 different ICUs during the 2-year period. Patients received either CHGIS dressings (January 2009-December 2009) or SDs (January 2010-December 2010). Primary outcomes measured were CLABSI rates per 1000 catheter days and ICU length of stay. There were 30 696 catheter days with CHGIS dressings and 31 319 catheter days with SDs. There was a statistically significant decrease in the rate of CLABSI per 1000 catheter days in the SD group, from 2.38 to 1.28 ( P = .001), with an absolute risk reduction of 1.1. There was a significantly lower incidence in the rate of CLABSI per 1000 catheter days in the SD group (incidence rate ratio [IRR] = 0.54, 95% confidence interval [CI]: 0.36-0.80). The relative risk of CLABSI in the SD group was 0.502 (95% CI: 0.340-0.730; P < .001). If SDs are used on all catheters, the decreased rate of CLABSIs observed would calculate to a cost savings of US$4070 to US$39 600 per 1000 catheter days. After successful implementation of the SD, we observed significant reductions in CLABSI rates and a sustained reduction in the subsequent 6 years. CONCLUSION Use of SDs is associated with a significant decrease in CLABSI rates in adult ICU patients compared to CHGIS dressings, with an estimated cost savings of US$4070 to US$39 600 per 1000 catheter days.
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Affiliation(s)
- Rachel Karlnoski
- 1 Department of Surgery, University of South Florida, Morsani College of Medicine, Tampa, FL, USA
| | - Elia Charbel Abboud
- 1 Department of Surgery, University of South Florida, Morsani College of Medicine, Tampa, FL, USA
| | - Peggy Thompson
- 2 Department of Infection Prevention, Tampa General Hospital, Tampa, FL, USA
| | - Asa Z Oxner
- 3 Department of Internal Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - John T Sinnott
- 4 Department of Internal Medicine, University of South Florida, Morsani College of Medicine, Tampa, FL, USA
| | - Jorge E Marcet
- 1 Department of Surgery, University of South Florida, Morsani College of Medicine, Tampa, FL, USA
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M Harriott M. In Vitro Antifungal-Antibacterial Combinations are Effective Against MRSA in Candida albicans-Staphylococcus aureus Polymicrobial Biofilms. ACTA ACUST UNITED AC 2016. [DOI: 10.15406/jmen.2016.03.00090] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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7
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Pammi M, Weisman LE. Late-onset sepsis in preterm infants: update on strategies for therapy and prevention. Expert Rev Anti Infect Ther 2015; 13:487-504. [DOI: 10.1586/14787210.2015.1008450] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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8
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Gupta A, Samra T, Banerjee N, Sood R. Management of central venous catheters in intensive care units: Comparative study of guidelines versus practice. Indian J Crit Care Med 2015; 19:54-6. [PMID: 25624654 PMCID: PMC4296415 DOI: 10.4103/0972-5229.148653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Arushi Gupta
- Department of Anaesthesia and Critical Care, Dr. Ram Manohar Lohia Hospital, New Delhi, India
| | - Tanvir Samra
- Department of Anaesthesia and Critical Care, PGIMER, Chandigarh, India
| | - Neerja Banerjee
- Department of Anaesthesia and Critical Care, Dr. Ram Manohar Lohia Hospital, New Delhi, India
| | - Rajesh Sood
- Department of Anaesthesia and Critical Care, Dr. Ram Manohar Lohia Hospital, New Delhi, India
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9
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Chen XX, Lo YC, Su LH, Chang CL. Investigation of the case numbers of catheter-related bloodstream infection overestimated by the central line-associated bloodstream infection surveillance definition. JOURNAL OF MICROBIOLOGY, IMMUNOLOGY, AND INFECTION = WEI MIAN YU GAN RAN ZA ZHI 2014; 48:625-31. [PMID: 24856425 DOI: 10.1016/j.jmii.2014.03.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/03/2013] [Revised: 02/14/2014] [Accepted: 03/13/2014] [Indexed: 01/06/2023]
Abstract
BACKGROUND/PURPOSE Diagnosis of catheter-related bloodstream infection (CRBSI) requires specific laboratory evidence. A simpler definition, central line-associated bloodstream infection (CLABSI), is recommended for surveillance purposes. Because exclusion of all other infection sources is difficult, CRBSI cases may be overestimated by using the CLABSI definition. METHODS A retrospective observational study was performed at a regional hospital in southern Taiwan from September 2012 to December 2013. All 106 reported CLABSI cases were assessed. Cases with catheter tip cultures were reviewed. CRBSI was defined as the identification of same organisms from the paired blood and catheter tip cultures (≥15 colony-forming units) without evidence of secondary bacteremia from other infection sources. RESULTS Overall, 64 cases were included and 31 (48.4%) were defined as CRBSI cases. In 30 (46.9%) cases, catheter tips were cultured after the corresponding blood cultures were performed. Later tip cultures were significantly more frequent in cases with other catheter types (18/22, 81.8%) than those with central lines (12/42, 28.6%; p < 0.0001). The same significant difference was also found among the CRBSI cases (central lines, 3/17, 17.6%; others, 13/14, 92.9%; p < 0.00005). Twelve bacterial species were identified from the CRBSI cases, with Staphylococcus aureus being the most frequent (13, 41.9%), followed by Pseudomonas aeruginosa (5, 16.1%). CONCLUSION The positive predictive value of the CLABSI definition for CRBSI cases was 48.4%. One should be aware of this discrepancy and should interpret the CLABSI surveillance definition with care.
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Affiliation(s)
- Xihn-Xuh Chen
- Department of Critical Care Medicine, Tainan Municipal Hospital, Tainan, Taiwan; Department of Internal Medicine, Tainan Municipal Hospital, Tainan, Taiwan
| | - Yi-Chu Lo
- Committee of Infection Control, Tainan Municipal Hospital, Tainan, Taiwan
| | - Lin-Hui Su
- Department of Laboratory Medicine, Chang Gung Memorial Hospital, Chang Gung University, College of Medicine, Kweishan, Taoyuan, Taiwan.
| | - Chin-Lu Chang
- Department of Internal Medicine, Tainan Municipal Hospital, Tainan, Taiwan; Committee of Infection Control, Tainan Municipal Hospital, Tainan, Taiwan.
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Bowdle A. Vascular Complications of Central Venous Catheter Placement: Evidence-Based Methods for Prevention and Treatment. J Cardiothorac Vasc Anesth 2014; 28:358-68. [DOI: 10.1053/j.jvca.2013.02.027] [Citation(s) in RCA: 91] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2013] [Indexed: 01/04/2023]
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11
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Hentrich M, Schalk E, Schmidt-Hieber M, Chaberny I, Mousset S, Buchheidt D, Ruhnke M, Penack O, Salwender H, Wolf HH, Christopeit M, Neumann S, Maschmeyer G, Karthaus M. Central venous catheter-related infections in hematology and oncology: 2012 updated guidelines on diagnosis, management and prevention by the Infectious Diseases Working Party of the German Society of Hematology and Medical Oncology. Ann Oncol 2014; 25:936-47. [PMID: 24399078 DOI: 10.1093/annonc/mdt545] [Citation(s) in RCA: 76] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Cancer patients are at increased risk for central venous catheter-related infections (CRIs). Thus, a comprehensive, practical and evidence-based guideline on CRI in patients with malignancies is warranted. PATIENTS AND METHODS A panel of experts by the Infectious Diseases Working Party (AGIHO) of the German Society of Hematology and Medical Oncology (DGHO) has developed a guideline on CRI in cancer patients. Literature searches of the PubMed, Medline and Cochrane databases were carried out and consensus discussions were held. RESULTS Recommendations on diagnosis, management and prevention of CRI in cancer patients are made, and the strength of the recommendation and the level of evidence are presented. CONCLUSION This guideline is an evidence-based approach to the diagnosis, management and prevention of CRI in cancer patients.
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Affiliation(s)
- M Hentrich
- Department of Hematology, Oncology and Palliative Care, Harlaching Hospital and Neuperlach Hospital, Munich
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12
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Tran PL, Hamood AN, Reid TW. Antimicrobial Coatings to Prevent Biofilm Formation on Medical Devices. SPRINGER SERIES ON BIOFILMS 2014. [DOI: 10.1007/978-3-642-53833-9_9] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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13
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Hospital-Acquired Waterborne Bloodstream Infection by Acinetobacter baumannii From Tap Water. INFECTIOUS DISEASES IN CLINICAL PRACTICE 2013. [DOI: 10.1097/ipc.0b013e31827f44d4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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14
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Togashi K, Nandate K, Hoaglan C, Sherman B, Bowdle A. A multicenter evaluation of a compact, sterile, single-use pressure transducer for central venous catheter placement. Anesth Analg 2013; 116:1018-1023. [PMID: 23492959 DOI: 10.1213/ane.0b013e31828a6e53] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Inadvertent arterial placement of a large-bore catheter during attempted placement of a central venous catheter (CVC) occurs at a rate of 0.1% to 1.0% and may result in hemorrhage, pseudoaneurysm, stroke, or death. Ultrasound guidance or observation of color and pulsatility of blood are not reliable methods for avoiding this serious complication. Measurement of pressure in the needle or short plastic catheter before insertion of the guidewire has been shown to be highly reliable; however, traditional pressure measurement methodology is cumbersome. Recently a compact, sterile, single-use pressure transducer with an integrated digital display has become available. In this study, we evaluated the performance of this new device (Compass® Vascular Access). METHODS In this prospective, observational study at 4 academic medical centers 298 CVCs were placed. Pressure was measured using the Compass transducer before and after guidewire insertion. Other details of the procedure were at the discretion of the clinician. Data describing the CVC placement and any complications were collected. RESULTS Trainees placed 279 of 298 CVCs. Ultrasound guidance was used for 286 of 298 CVCs. Seven of the CVC placements occurred in the intensive care unit, with the balance occurring in the operating room. Ten of the CVCs were placed in a subclavian vein, with the balance being internal jugular vein. Two hundred seventy-four of 298 CVCs were placed on the right side. Venous pressure measured before and after guidewire insertion was 7.2 ± 4.3 (SD) and 6.5 ± 4.3 (SD) mm Hg respectively (P = 0.03). The satisfaction score recorded by the physician performing the procedure was 8.0 ± 2.1 (SD; visual analog scale 1-10, 10 being most satisfying). There were 5 inadvertent arterial punctures (1.7%). Ultrasound guidance was used in all 5 cases of arterial puncture. All of the arterial punctures were recognized before guidewire insertion by measurement of arterial pressure with the Compass transducer. No guidewires or CVC catheters were placed in arteries. CONCLUSION The Compass pressure transducer for CVC placement performed as intended in 298 cases from 4 academic medical centers. There were 5 inadvertent arterial punctures despite the use of ultrasound guidance, all of which were correctly identified by pressure measurement using the Compass. The device was easily used by trainees, and users expressed a positive level of satisfaction.
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Affiliation(s)
- Kei Togashi
- From the Department of Anesthesiology, University of Washington; Department of Anesthesiology, Virginia Mason Medical Center, Seattle, Washington; and Department of Anesthesiology, Yale University, New Haven, Connecticut
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Boutaric E, Gilardi M, Cécile W, Fléchelles O. Impact d’un protocole de soins sur l’incidence des infections liées aux cathéters veineux épicutanéocaves chez le prématuré. Arch Pediatr 2013; 20:130-6. [DOI: 10.1016/j.arcped.2012.11.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2011] [Revised: 07/12/2012] [Accepted: 11/07/2012] [Indexed: 10/26/2022]
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16
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Antibacterial and antifouling catheter coatings using surface grafted PEG-b-cationic polycarbonate diblock copolymers. Biomaterials 2012; 33:6593-603. [DOI: 10.1016/j.biomaterials.2012.06.001] [Citation(s) in RCA: 255] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2012] [Accepted: 06/02/2012] [Indexed: 12/30/2022]
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