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Routine changing of intravascular administration sets does not reduce colonization or infection in central venous catheters


Rickard, CM and Lipman, J and Courtney, M and Siversen, R and Daley, P, Routine changing of intravascular administration sets does not reduce colonization or infection in central venous catheters, Infection Control and Hospital Epidemiology, 25, (8) pp. 650-655. ISSN 0899-823X (2004) [Refereed Article]

DOI: doi:10.1086/502456


OBJECTIVE: To determine the effect of routine intravenous (IV) administration set changes on central venous catheter (CVC) colonization and catheter-related bacteremia. DESIGN: Prospective, randomized, controlled trial. SETTING: Eighteen-bed intensive care unit (ICU) in a large metropolitan hospital. PARTICIPANTS: Two hundred fifty-one patients with 404 chlorhexidine gluconate and silver sulfadiazine-coated multilumen CVCs. INTERVENTIONS: CVCs inserted in the ICU and in situ on day 4 were randomized to have their IV administration sets changed on day 4 (n = 203) or not at all (n = 201). Use of fluid containers and blood product administration sets was limited to 24 hours. CVCs were removed when not required, infection was suspected, or in place on day 7. Catheter cultures were performed on removal by blinded laboratory staff. Catheter-related bacteremia was diagnosed by a blinded intensivist using strict definitions. Data were collected regarding catheter duration, site, Acute Physiology and Chronic Health Evaluation (APACHE) II score, patient age, diagnosis, hyperglycemia, hypoalbuminemia, immune status, number of fluid containers and IV injections, and administration of propofol, blood, total parenteral nutrition, or lipid infusion. RESULTS: There were 10 colonized CVCs in the group receiving a set change and 19 in the group not receiving one. This difference was not statistically significant on Kaplan-Meier survival analysis. There were 3 cases of catheter-related bacteremia per group. Logistic regression found that burns diagnosis and increased ICU stay significantly predicted colonization. CONCLUSION: IV administration sets can be used for 7 days in patients with short-term, antiseptic-coated CVCs.

Item Details

Item Type:Refereed Article
Research Division:Health Sciences
Research Group:Nursing
Research Field:Acute care
Objective Division:Health
Objective Group:Provision of health and support services
Objective Field:Nursing
UTAS Author:Rickard, CM (Dr Claire Rickard)
ID Code:40303
Year Published:2004
Web of Science® Times Cited:20
Deposited By:Health Sciences B
Deposited On:2006-08-31
Last Modified:2010-06-03

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