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

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Title Assessment of peripheral arterial catheters as a source of sepsis in the critically ill: a narrative review
Author Gowardman, John Robert; Lipman, J.; Rickard, Claire
Journal Name Journal of Hospital Infection
Year Published 2010
Place of publication United Kingdom
Publisher W.B. Saunders Co. Ltd.
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.
Peer Reviewed Yes
Published Yes
Alternative URI http://dx.doi.org/10.1016/j.jhin.2010.01.005
Copyright Statement Copyright 2010 The Healthcare Infection Society. This is the author-manuscript version of this paper. Reproduced in accordance with the copyright policy of the publisher. Please refer to the journal's website for access to the definitive, published version.
Volume 75
Issue Number 1
Page from 12
Page to 18
ISSN 0195-6701
Date Accessioned 2010-12-15
Language en_AU
Research Centre Centre for Health Practice Innovation; Griffith Health Institute
Faculty Griffith Health Faculty
Subject Clinical Sciences
URI http://hdl.handle.net/10072/35477
Publication Type Journal Articles (Refereed Article)
Publication Type Code c1

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