Cambio de catéter central programado al octavo día es superior al cambio guiado por signos de infección en pacientes críticamente enfermos

Translated title of the contribution: Programmed Central Line Change on the Eighth Day Is Better than Being Guided by Signs of Infection for Changing it in Critically-ill patients

Research output: Contribution to journalArticle

Abstract

Objectives. Comparing the efficacy of a protocol for scheduled central line change 8 days after insertion to local/systemic driven change protocol regarding the prevention of central venous or arterial catheter colonisation and infection. Design. Prospective, randomised clinical trial. Patients. All patients admitted to the ICU requiring central venous catheter insertion from August 1 st 2008 to October 31 st 2009. Patients were randomly assigned to one of two groups according to timing of central line exchange. In one group, venous catheter was removed by day 8, and in the other group, it was removed guided by local or systemic signs of infection. Measurements and Main Results. Catheter distal tips were quantitatively cultured in all patients. Significant catheter colonisation rate (i.e. > or = 10 3 colony-forming units [cfu]/mL by quantitative culture) and catheter-related sepsis (as defined by sepsis abating following catheter removal per 1,000 catheter-days) were significantly lower in the 8th day removal group (12 vs. 31 [0.4 relative risk; 0.1 to 0.9 95 % confidence interval; p > 0.1] and 6 vs. 16 [0.4 relative risk; 0.1 to 0.97 95 % confidence interval; p=0.05], respectively). Central venous catheter colonisation and central venous catheter-related sepsis rate per 1,000 catheter-days were also significantly lower in the 8th day removal group (8 vs. 31 [0.3 relative risk; 0.1 to 0.9 95 % confidence interval; p = 0.03] and 5 vs. 19 [0.3 relative risk; 0.1 to 0.9 95 % confidence interval; p = 0.02], respectively). Conclusions. The 8 th day catheter removal strategy was more effective than catheter removal strategy guided by signs of infection in terms of colonisation and catheter-related sepsis.

Original languageSpanish
Pages (from-to)445-455
Number of pages11
JournalRevista Colombiana de Anestesiologia
Volume38
Issue number4
StatePublished - Jan 1 2010

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Critical Illness
Catheters
Infection
Central Venous Catheters
Sepsis
Confidence Intervals
Stem Cells
Randomized Controlled Trials

Keywords

  • Catheter-related infections
  • Infection control
  • Sepsis

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine
  • Anesthesiology and Pain Medicine

Cite this

@article{d707b7a7cb9346e8bafa01821164d91c,
title = "Cambio de cat{\'e}ter central programado al octavo d{\'i}a es superior al cambio guiado por signos de infecci{\'o}n en pacientes cr{\'i}ticamente enfermos",
abstract = "Objectives. Comparing the efficacy of a protocol for scheduled central line change 8 days after insertion to local/systemic driven change protocol regarding the prevention of central venous or arterial catheter colonisation and infection. Design. Prospective, randomised clinical trial. Patients. All patients admitted to the ICU requiring central venous catheter insertion from August 1 st 2008 to October 31 st 2009. Patients were randomly assigned to one of two groups according to timing of central line exchange. In one group, venous catheter was removed by day 8, and in the other group, it was removed guided by local or systemic signs of infection. Measurements and Main Results. Catheter distal tips were quantitatively cultured in all patients. Significant catheter colonisation rate (i.e. > or = 10 3 colony-forming units [cfu]/mL by quantitative culture) and catheter-related sepsis (as defined by sepsis abating following catheter removal per 1,000 catheter-days) were significantly lower in the 8th day removal group (12 vs. 31 [0.4 relative risk; 0.1 to 0.9 95 {\%} confidence interval; p > 0.1] and 6 vs. 16 [0.4 relative risk; 0.1 to 0.97 95 {\%} confidence interval; p=0.05], respectively). Central venous catheter colonisation and central venous catheter-related sepsis rate per 1,000 catheter-days were also significantly lower in the 8th day removal group (8 vs. 31 [0.3 relative risk; 0.1 to 0.9 95 {\%} confidence interval; p = 0.03] and 5 vs. 19 [0.3 relative risk; 0.1 to 0.9 95 {\%} confidence interval; p = 0.02], respectively). Conclusions. The 8 th day catheter removal strategy was more effective than catheter removal strategy guided by signs of infection in terms of colonisation and catheter-related sepsis.",
keywords = "Catheter-related infections, Infection control, Sepsis",
author = "{Riveros Perez}, Efrain",
year = "2010",
month = "1",
day = "1",
language = "Spanish",
volume = "38",
pages = "445--455",
journal = "Revista Colombiana de Anestesiologia",
issn = "0120-3347",
publisher = "Sociedad Colombiana de Anestesiologia y Reanimacion SCARE",
number = "4",

}

TY - JOUR

T1 - Cambio de catéter central programado al octavo día es superior al cambio guiado por signos de infección en pacientes críticamente enfermos

AU - Riveros Perez, Efrain

PY - 2010/1/1

Y1 - 2010/1/1

N2 - Objectives. Comparing the efficacy of a protocol for scheduled central line change 8 days after insertion to local/systemic driven change protocol regarding the prevention of central venous or arterial catheter colonisation and infection. Design. Prospective, randomised clinical trial. Patients. All patients admitted to the ICU requiring central venous catheter insertion from August 1 st 2008 to October 31 st 2009. Patients were randomly assigned to one of two groups according to timing of central line exchange. In one group, venous catheter was removed by day 8, and in the other group, it was removed guided by local or systemic signs of infection. Measurements and Main Results. Catheter distal tips were quantitatively cultured in all patients. Significant catheter colonisation rate (i.e. > or = 10 3 colony-forming units [cfu]/mL by quantitative culture) and catheter-related sepsis (as defined by sepsis abating following catheter removal per 1,000 catheter-days) were significantly lower in the 8th day removal group (12 vs. 31 [0.4 relative risk; 0.1 to 0.9 95 % confidence interval; p > 0.1] and 6 vs. 16 [0.4 relative risk; 0.1 to 0.97 95 % confidence interval; p=0.05], respectively). Central venous catheter colonisation and central venous catheter-related sepsis rate per 1,000 catheter-days were also significantly lower in the 8th day removal group (8 vs. 31 [0.3 relative risk; 0.1 to 0.9 95 % confidence interval; p = 0.03] and 5 vs. 19 [0.3 relative risk; 0.1 to 0.9 95 % confidence interval; p = 0.02], respectively). Conclusions. The 8 th day catheter removal strategy was more effective than catheter removal strategy guided by signs of infection in terms of colonisation and catheter-related sepsis.

AB - Objectives. Comparing the efficacy of a protocol for scheduled central line change 8 days after insertion to local/systemic driven change protocol regarding the prevention of central venous or arterial catheter colonisation and infection. Design. Prospective, randomised clinical trial. Patients. All patients admitted to the ICU requiring central venous catheter insertion from August 1 st 2008 to October 31 st 2009. Patients were randomly assigned to one of two groups according to timing of central line exchange. In one group, venous catheter was removed by day 8, and in the other group, it was removed guided by local or systemic signs of infection. Measurements and Main Results. Catheter distal tips were quantitatively cultured in all patients. Significant catheter colonisation rate (i.e. > or = 10 3 colony-forming units [cfu]/mL by quantitative culture) and catheter-related sepsis (as defined by sepsis abating following catheter removal per 1,000 catheter-days) were significantly lower in the 8th day removal group (12 vs. 31 [0.4 relative risk; 0.1 to 0.9 95 % confidence interval; p > 0.1] and 6 vs. 16 [0.4 relative risk; 0.1 to 0.97 95 % confidence interval; p=0.05], respectively). Central venous catheter colonisation and central venous catheter-related sepsis rate per 1,000 catheter-days were also significantly lower in the 8th day removal group (8 vs. 31 [0.3 relative risk; 0.1 to 0.9 95 % confidence interval; p = 0.03] and 5 vs. 19 [0.3 relative risk; 0.1 to 0.9 95 % confidence interval; p = 0.02], respectively). Conclusions. The 8 th day catheter removal strategy was more effective than catheter removal strategy guided by signs of infection in terms of colonisation and catheter-related sepsis.

KW - Catheter-related infections

KW - Infection control

KW - Sepsis

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