A comparative study between conventional and antiseptic impregnated central venous catheters in neurocritical patients

Introduction

The central venous catheter (CVC) is very useful in the ICU. A comparative study between antiseptic impregnated and standard catheters is therefore of great value.

Methods

Alternating the type of CVC used in each patient, we recorded for each patient: sex, age, APACHE II score, GCS, site of the puncture, reason for withdrawal of the catheter and the type of catheter used. The tip of the catheter was cultured. The groups were divided: group I (41 patients, 54 punctures) used the standard CVC, and group II (38 patients, 54 punctures) used the impregnated CVC.

Results

Sixty-two patients were included (48.38% male). We studied 108 periods, of which 54 were standard CVCs and 54 were impregnated CVCs. The average length of stay was higher for impregnated CVCs (14.11 days) compared with standard CVCs (10.7 days). Excluding death in both groups, the length of stay of the catheter in group I was 10.86 days, compared with 15.43 days in group II. Adding all periods of catheterization, group I have an amount of 578 days, and 762 days for group II. The total duration for group II was 31.84% higher than for group I. Regarding the reason for withdrawal of the CVC, predominant were suspected infection 77.8% of the time for standard CVCs, and 49.1% of the time for impregnated CVCs. The culture of the catheter's tip was positive in 10 (18.5%) standard CVs, against eight (15.1%) CVCs in the impregnated group. Most patients had GCS <9.The average APACHE II score was17.97 in group I, compared with 19.63 in group II. The predominant site of puncture was the subclavian vein (56.48%). See Figure 1.

Figure 1

(abstract P387)

Conclusions

According to our study we observed that the length of stay with use of the impregnated CVC was higher (15.43 days). The rate of colonization was higher in the standard CVC. Patients who require a CVC for long periods have benefited with the use of impregnated CVCs, because they present long-term use, lower rates of colonization, and avoiding complications related to the procedure of successive punctures and related to the permanence of the catheters. The benefit reached by the use of antiseptic impregnated catheters compensated for the initial expensive cost of 40%.