Espina MD, Maldonado RNE

Language: Spanish
References: 12
Page: 236-240
PDF size: 131.65 Kb.

ABSTRACT

Most intravascular catheter-related infections are associated with central venous catheters. Intravascular catheter-related bloodstream infections are an important cause of illness and excess medical cost. In prospective studies, the relative risk for a catheter-related bloodstream infection is 2 to 855 times higher with central venous catheters than peripheral venous catheters. Approximately 80,000 catheter-related bloodstream infections occur in U.S. intensive-care units each year, at a cost of $296 million to $2.3 billion. These infections are associated with 2,400 to 20,000 deaths per year. The focus of this article is on preventive strategies aimed at central venous catheters. Technologic advances shown to reduce the risk for these infections include a catheter hub containing an iodinated alcohol solution, short-term chlorhexidine-silver sulfadiazine-impregnated catheters, minocycline-rifampin-impregnated catheters, and chlorhexidine-impregnated spong dressings. Nontechnologic strategies for reducing risk include maximal barrier precautions during catheter insertion, specialized nursing teams, continuing quality improvement programs, and tunneling of short-term internal jugular catheters. This practice is cost-effective and is consistent with the practice of universal precautions during an invasive procedure. The recommended procedures are hand washing, using full-barrier precautions during the insertion of central venous catheters, cleaning the skin with chlorhexidine, avoiding the femoral site if possible, and removing unnecessary catheters.

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