Skip Navigation LinksHome > April 2010 - Volume 38 - Issue 4 > Infectious risk associated with arterial catheters compared...
Critical Care Medicine:
doi: 10.1097/CCM.0b013e3181d4502e
Continuing Medical Education Articles

Infectious risk associated with arterial catheters compared with central venous catheters*

Lucet, Jean-Christophe MD, PhD; Bouadma, Lila MD; Zahar, Jean-Ralph MD; Schwebel, Carole MD; Geffroy, Arnaud MD; Pease, Sebastian MD; Herault, Marie-Christine MD; Haouache, Hakim MD; Adrie, Christophe MD; Thuong, Marie MD; Français, Adrien RT; Garrouste-Orgeas, Maïté MD; Timsit, Jean-François MD, PhD

Continued Medical Education
Collapse Box

Abstract

Background: Scheduled replacement of central venous catheters and, by extension, arterial catheters, is not recommended because the daily risk of catheter-related infection is considered constant over time after the first catheter days. Arterial catheters are considered at lower risk for catheter-related infection than central venous catheters in the absence of conclusive evidence.

Objectives: To compare the daily risk and risk factors for colonization and catheter-related infection between arterial catheters and central venous catheters.

Methods: We used data from a trial of seven intensive care units evaluating different dressing change intervals and a chlorhexidine-impregnated sponge. We determined the daily hazard rate and identified risk factors for colonization using a marginal Cox model for clustered data.

Results: We included 3532 catheters and 27,541 catheter-days. Colonization rates did not differ between arterial catheters and central venous catheters (7.9% [11.4/1000 catheter-days] and 9.6% [11.1/1000 catheter-days], respectively). Arterial catheter and central venous catheter catheter-related infection rates were 0.68% (1.0/1000 catheter-days) and 0.94% (1.09/1000 catheter-days), respectively. The daily hazard rate for colonization increased steadily over time for arterial catheters (p = .008) but remained stable for central venous catheters. Independent risk factors for arterial catheter colonization were respiratory failure and femoral insertion. Independent risk factors for central venous catheter colonization were trauma or absence of septic shock at intensive care unit admission, femoral or jugular insertion, and absence of antibiotic treatment at central venous catheter insertion.

Conclusions: The risks of colonization and catheter-related infection did not differ between arterial catheters and central venous catheters, indicating that arterial catheter use should receive the same precautions as central venous catheter use. The daily risk was constant over time for central venous catheter after the fifth catheter day but increased significantly over time after the seventh day for arterial catheters. Randomized studies are needed to investigate the impact of scheduled arterial catheter replacement. (Crit Care Med 2010; 38:1030–1035)

© 2010 by the Society of Critical Care Medicine and Lippincott Williams & Wilkins

Article Tools

Share

Search for Similar Articles
You may search for similar articles that contain these same keywords or you may modify the keyword list to augment your search.