Assessment of peripheral arterial catheters as a source of sepsis in the critically ill: A narrative review

Gowardman, J. R., Lipman, J. and Rickard, C. M. (2010) Assessment of peripheral arterial catheters as a source of sepsis in the critically ill: A narrative review. Journal of Hospital Infection, 75 1: 12-18. doi:10.1016/j.jhin.2010.01.005


Author Gowardman, J. R.
Lipman, J.
Rickard, C. M.
Title Assessment of peripheral arterial catheters as a source of sepsis in the critically ill: A narrative review
Journal name Journal of Hospital Infection   Check publisher's open access policy
ISSN 0195-6701
1532-2939
1475-9594
Publication date 2010-05
Sub-type Critical review of research, literature review, critical commentary
DOI 10.1016/j.jhin.2010.01.005
Volume 75
Issue 1
Start page 12
End page 18
Total pages 7
Place of publication London, United Kingdom
Publisher WB Saunders Co. Ltd.
Collection year 2011
Language eng
Abstract Intravascular devices (IVDs) are essential in the management of critically ill patients; however, IVD-related sepsis remains a major complication. Arterial catheters (ACs) are one of the most manipulated IVDs in critically ill patients. When bloodstream infection (BSI) is suspected in a patient with an IVD in situ, clinicians have focused their attention on the central venous catheter (CVC) while largely ignoring the AC. Although it would be routine for the CVC to be cultured and replaced if necessary for suspected IVD or catheter-related sepsis, the AC may not be treated in the same manner. The reasons for this may in part relate to the patient groups studied. In lower acuity patients with short dwell times, AC sepsis rates are indeed low. In the higher acuity patient, earlier studies suggested that ACs had an infective potential at least equal to short term CVCs, a finding that has translated poorly into clinical practice. It has been estimated that there may be up to 48 000. BSIs per year arising from ACs in the USA alone, suggesting a significant clinical problem. Recent evidence now shows that the infective potential of the AC is comparable with that in short term CVCs regarding both colonisation (which precedes BSI) and BSI, consolidating earlier studies. In critically ill patients suspected of catheter-related bloodsteam infection it is suggested that both the AC and CVC must now be assessed together. © 2010 Published by Elsevier Ltd on behalf of The Hospital Infection Society.
Keyword Arterial catheter
Bloodstream infection
Catheter-related bloodstream infection
Critical illness
Sepsis
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ
Additional Notes Published under heading: Review

Document type: Journal Article
Sub-type: Critical review of research, literature review, critical commentary
Collections: Official 2011 Collection
School of Medicine Publications
 
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Created: Sun, 13 Jun 2010, 00:03:25 EST