Central venous catheter replacement strategies
Critical Care MedicinePublished 1 August 1997
Fadi Hammal, Adrienne G. Randolph, Phillip Kernerman, Cynthia Cupido, Derek King, Clara Soukup
Citations324
SJR quartileQ1
SJR score2.12
SNIP2.15
Generate an AI Snapshot to get a quick, structured summary of this paper.
Study Snapshot
ObjectiveStudy objective
MethodsResearch methodology
PopulationPopulation studied
Sample sizeSample sizes
OutcomesStudy outcomes here
ResultsStudy results comes here
LimitationsResearch study limitations comes here
A concise AI-generated summary of the paper will appear here once you click Generate AI Snapshot.
TL;DR
Guidewire exchange of central venous catheters may be associated with a greater risk of catheter-related infection but fewer mechanical complications than new-site replacement and more studies on scheduled vs. as-needed replacement strategies are warranted.
Abstract
Guidewire exchange of central venous catheters may be associated with a greater risk of catheter-related infection but fewer mechanical complications than new-site replacement. More studies on scheduled vs. as-needed replacement strategies using both techniques are warranted. If guidewire exchange is used, meticulous aseptic technique is necessary.
Keywords
MedicineHealth Professions
CHEST JournalDefinitions for Sepsis and Organ Failure and Guidelines for the Use of Innovative Therapies in Sepsis
13,045 Citations1992Roger C. Bone, R.A. Balk +6 more
Broad definitions of sepsis and the systemic inflammatory response syndrome were proposed, along with detailed physiologic parameters by which a patient may be categorized, and the use of severity scoring methods when dealing with septic patients was recommended as an adjunctive tool to assess mortality.
JAMAEmpirical evidence of bias. Dimensions of methodological quality associated with estimates of treatment effects in controlled trials
5,580 Citations1995Klaus‐Peter Schulz
Empirical evidence is provided that inadequate methodological approaches in controlled trials, particularly those representing poor allocation concealment, are associated with bias.
Acta RadiologicaCatheter Replacement of the Needle in Percutaneous Arteriography: A new technique
3,255 Citations1953S. I. Seldinger
New England Journal of MedicineA Semiquantitative Culture Method for Identifying Intravenous-Catheter-Related Infection
2,064 Citations1977Dennis G. Maki, Carol E. Weise +1 more
The semiquantitative technic distinguishes infection (greater than or equal to 15 colonies) from contamination and is more specific in diagnosis of catheter-related septicemia than culture of the catheter in broth.
Statistical Methods in Medical ResearchReview papers : The statistical basis of meta-analysis
1,243 Citations1993JL Fleiss
Two models for study-to-study variation in a meta-analysis are presented, critiqued and illustrated and the application of both models to three summary measures of the effect of an experimental intervention versus a control is illustrated.
Annals of Internal MedicineThe Use of Predicted Confidence Intervals When Planning Experiments and the Misuse of Power When Interpreting Results
633 Citations1994Steven N. Goodman, Jesse A. Berlin
The problems with the framework of statistical power are elucidated in the course of explaining why post hoc estimates of power are of little help in interpreting results and why the focus of attention should be exclusively on confidence intervals.
Archives of Internal MedicineCentral vein catheterization. Failure and complication rates by three percutaneous approaches
630 Citations1986Jacob I. Sznajder
Archives of Internal MedicineDiagnosis of central venous catheter-related sepsis. Critical level of quantitative tip cultures
471 Citations1987Christian Brun‐Buisson
The American Journal of MedicineThe pathogenesis and epidemiology of catheter-related infection with pulmonary artery Swan-Ganz catheters: A prospective study utilizing molecular subtyping
442 Citations1991Leonard A. Mermel, Rita D. McCormick +2 more
Swan-Ganz catheters are vulnerable to contamination from multiple sources, but the patient's skin is the single most important source of organisms causing invasive infection, which in most cases involves the introducer rather than the PA catheter.
New England Journal of MedicineA Controlled Trial of Scheduled Replacement of Central Venous and Pulmonary-Artery Catheters
439 Citations1992David K. Cobb, Kevin P. High +7 more
Archives of Internal MedicineDiagnosis of Central Venous Catheter-Related Sepsis
399 Citations1987Christian Brun‐Buisson
The QTC appeared especially useful for the diagnosis of CRS secondary to blood-borne seeding of catheters, or associated with coagulase-negative staphylococci, as opposed to contamination or simple colonization from a distant septic focus.
Archives of Internal MedicineNosocomial Infection and Fatality in Medical and Surgical Intensive Care Unit Patients
361 Citations1988Donald E. Craven
The MICU patients had a higher fatality rate in the MICU than did the SICU patients, but the relative risk of a death following nosocomial infection was 3.5 for both groups, and thirty variables were significantly associated with hospital fatality; nine remained significant after analysis by stepwise logistic regression.
British journal of surgeryCatheter-related sepsis in patients on intravenous nutrition: A prospective study of quantitative catheter cultures and guidewire changes for suspected sepsis
161 Citations1985Ross A. Pettigrew, S. D. R. Lang +4 more
Replacement of catheters over a guidewire is a safe and convenient way of establishing whether sepsis is catheter‐related, and because organisms may be transferred, the procedure is not an appropriate treatment for catheter-related sepsi.
The American Journal of MedicineCentral catheter infections: Single- versus triple-lumen catheters
142 Citations1988Eileen Hilton, T. M. Haslett +4 more
The use of a guide wire to place a new line over an old one also was associated with a trend towards an increased risk of infection, which was three times greater than that of the single-lumen catheters.
American Journal of Respiratory and Critical Care MedicineInfectious Complications of Swan-Ganz Pulmonary Artery Catheters. Pathogenesis, Epidemiology, Prevention, and Management
140 Citations1994Leonard A. Mermel, D G Maki
The Journal of Infectious DiseasesProspective Study of Catheter Replacement and Other Risk Factors for Infection of Hyperalimentation Catheters
139 Citations1986C Armstrong, C. G. Mayhall +6 more
To determine risk factors for infection of hyperalimentation catheters, prospectively studied 169 catheter systems by using a semiquantitative culture technique and estimated the risk of infection per day to be 1.3 times greater for a catheter if the patient had been hospitalized 50 days instead of seven days, and 3.8 times greater if the customer had a Swan-Ganz catheter at the time of insertion.
Journal of Clinical OncologyA prospective randomized trial evaluating prophylactic antibiotics to prevent triple-lumen catheter-related sepsis in patients treated with immunotherapy.
106 Citations1990Steven Bock, R E Lee +8 more
This trial demonstrates that treatment with prophylactic oxacillin can decrease the incidence of catheter-related sepsis in patients undergoing immunotherapy with interleukin-2 (IL-2) alone or with immune cells.
CHEST JournalCatheter-Related Infections and Associated Septicemia
90 Citations1991Scott H. Norwood, Allan Ruby +2 more
The evidence presented more likely implicates predisposing damage from prior episodes of PCP or, more likely, ongoing tissue damage in patients receiving aerosolized pentamidine prophylaxis.
PubMedThe clinical impact of culturing central venous catheters. A prospective study.
89 Citations1992Andreas F. Widmer, Mary D. Nettleman +2 more
Critical Care MedicineInfectious and mechanical complications of central venous catheters placed by percutaneous venipuncture and over guidewires
74 Citations1992Michael T. Hagley, Bradley C. Martin +2 more
When prolonged central venous or pulmonary artery catheterization is necessary, periodic catheter replacement over a guidewire is associated with fewer mechanical complications than initial venipuncture and is also associated with no increase in risk of infection.
Archives of Internal MedicineThe Clinical Impact of Culturing Central Venous Catheters
66 Citations1992Andreas F. Widmer
A prospective observational study evaluated the clinical impact of the semiquantitative culture results on the treatment of the patient and found newer laboratory techniques that do not require removal of the catheter are needed to guide therapeutic decisions.
Journal of Parenteral and Enteral NutritionEffect of Frequent Guidewire Changes on Triple‐Lumen Catheter Sepsis
63 Citations1988Carla Powell, Kenneth A. Kudsk +3 more
Prophylactic guidewire changes did not alter the incidence of catheter sepsis in patients with TLC who required TPN and may be due to the critical illness of the immunocompromised population studied.
Annals of SurgeryCatheter Infection
53 Citations1988RICHARD H. SNYDER, FRANK J. ARCHER +7 more
Study results indicate no significant difference in infection or colonization rates Between the two methods of catheter replacement.
PubMedPulmonary artery catheterization: a prospective study of internal jugular and subclavian approaches.
52 Citations1987Anthony J. Senagore, James D. Waller +3 more
Critical Care MedicinePulmonary artery catheterization
49 Citations1987Anthony J. Senagore, James D. Waller +3 more
Using a standard, sterile-insertion technique and a catheter-maintenance protocol yielded a low risk of insertion and infectious complications at either the IJ or SC site, indicating that PACs can be changed safely over a guidewire at 72 h, avoiding further insertion risks without increasing infectious complications.
Intensive Care MedicineCatheter related infection. A plea for consensus with review and guidelines
46 Citations1988Michael Plit, Jeffrey Lipman +2 more
This paper analyses the various factors that have contributed to inconsistencies in catheter management techniques and thereby attempts to provide a standardised framework for future research and communication on the subject.
Critical Care MedicineSensitivity and specificity of blood cultures obtained through intravascular catheters
40 Citations1990Gary P. Wormser, Ida M. Onorato +3 more
Catheter blood cultures were found to be 96% sensitive and 98% specific for the detection of septicemia and factors thought to have influenced these favorable results were the relatively short duration of catheter placement and the particular emphasis given to aseptic technique.
PubMedSafety of central venous catheter change over guidewire for suspected catheter-related sepsis. A prospective randomized trial.
37 Citations1989Luc Michel, H. Bradpiece +2 more
It is concluded that changing a central venous catheter over a guidewire is as safe and has better patient acceptability than inserting a new one, as the proven CRS rate is low (2%) despite a high (27%) suspected rate.
CHEST JournalGuidewire Catheter Change in Central Venous Catheter Biofilm Formation in a Burn Population
31 Citations1991Kinga Kowalewska‐Grochowska, R. J. Richards +4 more
Of the catheters defined as colonized by SEM, the special culture technique showed bacterial growth in only 35 percent, making a negative culture result of dubious value in ruling out catheter colonization.
Journal of Parenteral and Enteral NutritionMechanical Complications from Insertion of Subclavian Venous Feeding Catheters: Comparison of de Novo Percutaneous Venipuncture to Change of Catheter Over Guidewire
31 Citations1984Heber H. Newsome, Carl W. Armstrong +5 more
It is concluded that change over a guidewire is an acceptable alternative to contralateral de novo percutaneous subclavian venipuncture for feeding catheter insertion in view of fewer mechanical complications and greater ease of insertion.
Prospective Comparison of Two Management Strategies of Central Venous Catheters in Burn Patients
28 Citations1995G P Kealey, Phyllis Chang +3 more
Changing the CVC using the wire guide technique did not prevent, nor predict, CVC bacterial contamination, and there was no difference in the incidence of CVC sepsis between the two groups studied.
PubMedSubclavian catheter changes every third day in high risk patients.
28 Citations1985Jay A. Gregory, William R. Schiller
The authors conclude from this study that the incidence of positive catheters is significant in this high-risk group, but is decreased when the routine change protocol is implemented.
Journal of Cardiothoracic and Vascular AnesthesiaSafety of a guidewire technique for replacement of pulmonary artery catheters
11 Citations1992Alfons Bach, H. Böhrer +1 more
The results show that insertion of CVCs over a guidewire within 48 hours after initial venapuncture is no more likely to be associated with catheter colonization than is de novo percutaneous insertion at a different site.