Catheter-related bloodstream infections occur in 3-8 percent of insertions, and are the highest cause of nosocomial bloodstream infections in the ICU.
The most effective measures to prevent catheter-related infections are as follows:
Especially applicable to those of us placing these lines in the ED or in the ICU is the last recommendation, based on a prospective study from Greece
-adequate knowledge and use of care protocols
-qualified personnel involved in changing and care
-use of biomaterials that inhibit microorganism growth and adhesion
-good hand hygiene
-use of an alcoholic formulation of chlorhexidine for skin disinfection and manipulation of the vascular line
-preference for subclavian route for placement
-use of full barrier protection during placement
-removal of unnecessary catheters
-use of ultrasound for placement of central lines
References
Frasca D, Dahyot-Fizelier C, Mimoz O: Prevention of central venous catheter-related infection in the intensive care unit. Crit Care; 2010; 14:212
Karakitsos D, Labropoulos N, De Groot E: Real time ultrasound guided catheterisation of the internal jugular vein: A prospective comparison with the landmark technique in critical care patients. Crit Care 2006; 10(6):175.
