Articles  |   February 2016
SEE Question
Article Information
Critical Care / Infectious Disease / Articles
Articles   |   February 2016
SEE Question
ASA Monitor 02 2016, Vol.80, 54-55.
ASA Monitor 02 2016, Vol.80, 54-55.
You are planning to place a radial arterial catheter for invasive blood pressure monitoring of a critically ill patient in the intensive care unit (ICU). You anticipate that invasive blood pressure monitoring will be needed for more than five days. According to a recent meta-analysis, which of the following actions is most likely associated with a significantly decreased risk of catheter-related infection?
Despite the fact that millions of arterial catheters are inserted each year in the United States, their placement remains an underappreciated source of catheter-related bloodstream infections (CRBSIs) in the ICU. The Joint Commission recommends regular culture surveys of central venous catheters but not arterial lines. Currently, the known risk of arterial-related CRBSI is 0 to 4 percent. A recent systematic review and meta-analysis yielded 49 studies documenting 202 arterial-line, ICU-based CRBSIs from more than 30,000 arterial catheter placements. This translates into an overall rate of 3.4 infections per 1,000 arterial catheter placements, or 0.96 infections per 1,000 arterial catheter days. Studies in which all arterial catheters were cultured, compared to only those thought to be a source of infection, yielded a CRBSI rate of 1.26 per 1,000 catheter days versus 0.7 per 1,000 catheter days.
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