Safety of central venous catheter change over guidewire for suspected catheter-related sepsis. A prospective randomized trial.
(1988) International Surgery — Vol. 73, n° 3, p. 180-186 (1988)
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- Abstract
- We conducted a study to determine the safety of guidewire exchange of central venous catheters suspected of causing catheter-related sepsis (CRS). Out of a total of 146 patients studied prospectively 41 (28%) suspected of having CRS, were randomly allocated to have their catheters changed over a guidewire (group I) or replaced by a new contralateral venipuncture (group II). One hundred and five patients (group III) requiring only one catheterization served as a control group. Positive semiquantitative cultures (greater than or equal to 15 colonies per plate) of the catheter tip constituted a reliable index of CRS (positive and negative predictive value of 100%). No significant difference in catheter contamination rate and CRS rate was found between group I and II (p = 0.13) and between group I and II versus group III. Nevertheless, there were fewer problems of insertion in the guidewire group (p = 0.03). We conclude that changing a central venous catheter over a guidewire is as safe and has better patient acceptability than inserting a new one, as the proven CRS rate is low (2%) despite a high (27%) suspected rate.
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Michel, L., Bradpiece, H. A., Randour, P., & Pouthier, F. (1988). Safety of central venous catheter change over guidewire for suspected catheter-related sepsis. A prospective randomized trial. International Surgery, 73(3), 180-186. https://hdl.handle.net/2078.5/68691 (Original work published 1988)