5000 days of central venous catheterization: complications

Objective

To analyze complications of central venous catheterization in Critical Care.

Methods

It is a prospective study in a 20-bed medical surgical ICU. Included were all patients admitted from 1 May 2000 to 31 December 2000.

Results

Included were 400 patients (233 males). Mean age was 56.80 ± 17.27 years, APACHE-II was 13.23 ± 5.25. Mortality was 16.50%. Patients distribution was: 185 cardiac surgery, 35 cardiologic, 23 pulmonary, 16 digestive, 51 neurologic, 43 traumathology, 13 intoxication, 32 sepsis and two others. The number of catheter and length stay of catheter (days) were: global 706 and 4980, peripheral access 145 and 949, jugular306 and 1806, subclavian 190 and 1694, femoral 65 and 531. Central venous catheter related infections per 100 catheter and per 1000 days of catheterization were: general 3.40 and 4.81, peripheral access 1.64 and 2.52, jugular 3.6 and 6.20, subclavia 1.68 and 1.88, femoral 11.11 and 13.55. Bloodstream infections secondary to central venous catheter per 1000 days of catheterization were: general 1.44, peripheral site 0.84, jugular 0.88, subclavian 1.41, femoral 4.51. Pneumothorax secondary to central venous catheterization: general 1.29% (8/619), subclavian 1.68% (4/237), jugular 1.04% (4/382). The groups of microorganisms found were: 62.4% Gram positives, 25.2% Gram negatives and 12.4% fungi. The microorganisms isolated were: staphylococcus coagulase negative 58.33%, bacillus 4.16%, Escherichia coli 8.33%, serratia 4.16%, Pseudomonas aeruginosa 4.16%, Morganella morganii 4.16%, Candida albicans 8.33%, Candida tropicalis 4.16%, enterobacter 4.16%.

Conclusions

We have a low rate of central venous catheter complications. Femoral venous catheterization is the site with more catheter related infections.