Catheter dressings

Abstract:

Short-term intravascular catheters are instrumental in the care of critically ill patients to allow safe intravenous administration of medications or fuid resuscitation and the monitoring of hemodynamic parameters. Due to high utilization rate of intravascular catheters, infections associated to these devices represent an important burden of infections acquired in the intensive care unit (ICU) which impact morbidity, length-of stay and mortality [1]. In Europe, the mean central-line (CVC) associated bloodstream infection rate in critically ill patients was 3.7 episodes per 1000 CVC-days. Te infection of the catheter can occur by two main pathways: the extraluminal route or the intraluminal route. Te extraluminal route (i.e., colonization and subsequent infection of the catheter from its dermal surface) plays the predominant role for short-term intravascular catheters. In this context, dressing disruptions of catheter are frequently observed and are one of the most important risk factors for intravascular catheter infections [2]. Of note, dressing disruption occurred more frequently in patients with higher Sequential Organ Failure Assessment (SOFA) scores, with a body mass index (BMI)>40, receiving renal replacement therapies and less frequently in subclavian catheters [2]. Moreover, catheter dressing integrity is essential in preventing catheter dislodgement, which represents a frequent cause of catheter failure [3]. Enhanced eforts to improve catheter care and reduce dressing disruption should therefore be prioritized as a preventive measure (Fig. 1).

 

Reference:

Buetti, N, Rickard, CM & Timsit, JF 2022, ‘Catheter dressings’, Intensive Care Med, https://doi.org/10.1007/s00134-022-06734-w

 

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