Table 1 |
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New technologies for the prevention of central venous catheter-related bloodstream infection |
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| Technology |
Usefulness |
Grade * |
Note |
|
|
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| Antimicrobial impregnated dressings |
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| Chlorhexidine impregnated sponge dressing |
Short-term CVCs |
NR |
Consider for CVCs expected to be in place for >5 days |
| Silver impregnated subcutaneous collagen cuff |
Short-term CVCs |
NR |
Conflicting results in several clinical trials of efficacy |
| Antimicrobial impregnated catheters |
IB |
Consider if institutional rate of CRBSI is high despite consistent application of
preventive measures and CVC is expected to be in place for >5 days |
|
| Chlorhexidine–silver sulfadiazine impregnated catheters |
Short-term CVCs |
Only the external surface of the CVC is coated. Not effective for CVCs left in place
for >2 weeks |
|
| Minocycline–rifampin impregnated catheters |
Short-term and long-term CVCs |
Both the internal and external surfaces of the CVC are coated. Prolonged antimicrobial
activity |
|
| Hubs |
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| Catheter hub contained a iodinated alcohol solution |
Long-term CVCs |
NR |
A recent trial failed to show any preventive benefit from the use of this hub |
| Povidone–iodine satured sponge |
Long-term CVCs |
NR |
|
| Needleless connectors |
NR |
Increased risk for CRBSI associated with improper use |
|
| Antimicrobial lock solutions |
Long-term CVCs |
II |
Consider only for patients with recurrent CRBSIs despite consistent application of
preventive measures |
|
|
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* Adapted from the Centers for Disease Control and Prevention guidelines for the prevention of intravascular catheter-related infections [1]. Category IB: strongly recommended for implementation and supported by some experimental, clinical, or epidemiologic studies, and a strong theoretical rationale. Category II: suggested for implementation and supported by suggestive clinical or epidemiologic studies or a theoretical rationale. NR: no recommendations for or against use at this time. CRBSI, catheter-related bloodstream infection; CVC, central venous catheter. |
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Cicalini et al. Critical Care 2004 8:157 doi:10.1186/cc2380 |
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