Femoral central lines and clinical sepsis

Objective

Femoral central lines are traditionally believed to have a higher risk of septic complications when compared with neck lines. Our study looked at the incidence of catheter-related blood stream infections and local sepsis from femoral central lines placed in the medical intensive care unit (MICU).

Methods

A prospective observational study of central venous catheters placed in the femoral veins over a 4 month period. The patients were assessed daily for evidence of local infection (erythema, purulent discharge) or catheter-related blood stream infections (CRBSI). CRBSI was defined by a) clinical evidence of new sepsis (fever or leukocytosis) plus b) isolation of the same bacteria from the culture of the catheter tip and a peripheral blood culture.

Results

Sixty catheters were placed in 53 patients with a total of 367 catheter days. The mean duration of catheter placement was 6.1 days. There was one case of CRBSI (1.66% or 2.7 per 1000 catheter days) and no incidence of local infection.

Conclusion

Femoral central venous lines, when placed over an average duration of 1 week, have a low incidence of septic complications. The rate compares favourably with the data from neck catheterization.