Faculty Collaboration Database

Strategies for the prevention of central venous catheter infections: an American Pediatric Surgical Association Outcomes and Clinical Trials Committee systematic review. J Pediatr Surg 2011 Oct;46(10):2000-11

Date

10/20/2011

Pubmed ID

22008341

DOI

10.1016/j.jpedsurg.2011.06.017

Scopus ID

2-s2.0-80054744498 (requires institutional sign-in at Scopus site)   67 Citations

Abstract

PURPOSE: The aim of this study is to review the current evidence-based data regarding strategies for prevention of central venous catheter (CVC) infections at the time of catheter insertion and as a part of routine care.

METHODS: We conducted a PubMed search from January 1990 to November 2010 using the following keywords: central venous catheter, clinical trials, pediatric, infection, prevention, antibiotic, chlorhexidine, dressing, antiseptic impregnated catheters, ethanol lock, impregnated cuff, insertion site infection, and Cochrane systematic review. Seven questions, selected by the American Pediatric Surgical Association Outcomes and Clinical Trials Committee, were addressed.

RESULTS: Thirty-six studies were selected for detailed review based on the strength of their study design and relevance to our 7 questions. These studies provide evidence that (1) chlorhexidine skin prep and chlorhexidine-impregnated dressing can decrease CVC colonization and bloodstream infection, (2) use of heparin and antibiotic-impregnated CVCs can decrease CVC colonization and bloodstream infection, and (3) ethanol and vancomycin lock therapy can reduce the incidence of catheter-associated bloodstream infections.

CONCLUSION: Grade A and B recommendations can be made based on available evidence in adult and limited pediatric studies for multiple components of proper CVC insertion practices and subsequent management. These strategies can minimize the risk of CVC infections in pediatric patients.

Author List

Huang EY, Chen C, Abdullah F, Aspelund G, Barnhart DC, Calkins CM, Cowles RA, Downard CD, Goldin AB, Lee SL, St Peter SD, Arca MJ, 2011 American Pediatric Surgical Association Outcomes and Clinical Trials Committee

Author

Casey Matthew Calkins MD Professor in the Surgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Anti-Bacterial Agents
Anti-Infective Agents, Local
Antibiotic Prophylaxis
Bacteremia
Bandages
Case-Control Studies
Catheter-Related Infections
Catheterization, Central Venous
Chlorhexidine
Coated Materials, Biocompatible
Disinfection
Equipment Contamination
Ethanol
Evidence-Based Medicine
Heparin
Humans
Meta-Analysis as Topic
Organ Specificity
Povidone-Iodine
Practice Guidelines as Topic
Randomized Controlled Trials as Topic