Intensive Care Medicine

, Volume 28, Issue 1, pp 18–28

Central venous catheter use

Part 2: infectious complications
  • K. Polderman
  • A. Girbes

DOI: 10.1007/s00134-001-1156-7

Cite this article as:
Polderman, K. & Girbes, A. Intensive Care Med (2002) 28: 18. doi:10.1007/s00134-001-1156-7


Central venous catheters (CVCs) are used with increasing frequency in the intensive care unit and in general medical wards. Catheter infection, the most frequent complication of CVC use, is associated with increased morbidity, mortality, and duration of hospital stay. Risk factors in the development of catheter colonisation and bloodstream infection include patient factors (increased risk associated with malignancy, neutropenia, and shock) and treatment-related factors (increased risk associated with total parenteral nutrition, ICU admission for any reason, and endotracheal intubation). Other risk factors are prolonged catheter indwelling time, lack of asepsis during CVC insertion, and frequent manipulation of the catheter. The most important factor is catheter care after placement. Effects of CVC tunnelling on infection rates depend to a large extent on indwelling time and the quality of catheter care. Use of polyurethane dressings can increase the risk of colonisation compared to regular gauze dressing. Thrombus formation around the CVC tip increases the risk of infection; low-dose anticoagulants may decrease this risk. New developments such as CVC impregnation with antibiotics may reduce the risk of infection. Reducing catheter infection rates requires a multiple-strategy approach. Therefore, ICUs and other locations where CVCs are used should implement strict guidelines and protocols for catheter insertion, care, and maintenance.

Central venous catheter Infectious complications Catheter-related bacteraemia Colonisation Catheter-related sepsis Preventive strategy Literature review 

Copyright information

© Springer-Verlag 2001

Authors and Affiliations

  • K. Polderman
    • 1
  • A. Girbes
    • 1
  1. 1.Department of Intensive Care, VU University Medical Center, PO Box 7057, 1007 MB AmsterdamThe Netherlands

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