Major ArticlesPrevention of catheter-related bloodstream infection in critically ill patients using a disinfectable, needle-free connector: A randomized controlled trial☆
Section snippets
Material and methods
A randomized controlled trial was designed in a 12-bed polyvalent ICU in a 420-bed university hospital. Critically ill patients who fulfilled all selection criteria were consecutively recruited and randomly assigned to one of two study groups on the insertion of the first central venous catheter (CVC). Inclusion criteria were the need for a subclavian or jugular nontunneled, noncoated, polyurethane central venous multilumen catheter. CVCs inserted outside the ICU, removed before 72 hours of
Results
A total of 243 patients met the selection criteria and were randomized to one of the 2 treatment arms. In all, 278 catheters were inserted, with a maximum of 7 catheters per patient and with a mean duration of insertion of 9.9 days. From the 278 catheters studied, 91 (32.7%) corresponded to medical patients, 101 (36.3%) to surgical patients, and 86 (31.0%) to trauma patients. The mean of the severity of patients' illnesses on admission according to SAPS II was 34.0 (SD 12.1), and the mean of
Discussion
This study shows a reduction in the number of CRBI cases in the group that used a disinfectable, needle-free connector. It included only a selected population of multilumen central venous catheters inserted in critically ill patients for more than 72 hours. This type of catheter is particularly susceptible to bacterial colonization through handling because it is used for different purposes at the same time, such as central venous pressure monitoring, blood sampling, administration of TPN,
Acknowledgements
The authors thank the nurses at the Intensive Care Unit of the “Dr Josep Trueta” University Hospital of Girona.
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Desinfectable needle-free connectors were provided by Alaris Medical Systems (San Diego, Calif) without charge.