Prevention of intravascular catheter-related infections—25 years later

Catheter insertionSubcutaneous tunneling short-term CVCs inserted in the internal jugular or femoral veins when CVCs are not used for drawing blood Yes No Full barrier precautions during CVC insertion Yes Yes Contamination shield for pulmonary artery catheters Yes Yes Preparation of insertion site with CHG-containing antiseptics Yes Yes, use alcoholic CHG Prophylaxis with vancomycin and other therapeutic agents No No Femoral vein catheter insertion No No Subclavian vein rather than internal jugular vein CVC insertion Yes Yes Preparation of insertion site with tincture of iodine Yes Yes, if alcoholic CHG unavailable Full barrier precautions during insertion of midline, peripheral artery, and pulmonary artery catheters Yes Yes Catheter maintenance Routine replacement of CVCs No Consider replace in 10-14 d*C hlorhexidine-silver sulfadiazine-impregnated short-term CVCs Yes Yes, if CRBSI rate high Low-dose heparin for patients with short-term CVCs Yes No Specialized nursing teams caring for patients with short-term peripheral venous catheters at institutions with a high incidence of infection Yes Yes Povidone-iodine ointment applied to hemodialysis catheter insertion sites Yes No Hub with chamber filled with iodinated alcohol for CVC with an expected duration of approximately 2 weeks Yes No, use alcohol-containing end cap Povidone-iodine-saturated sponge enclosed in plastic casing fitted around the hubs of central venous catheters with an expected 2-week duration Yes No Minocycline-rifampin-impregnated short-term CVCs Yes Yes, if CRBSI rate high Triple antibiotic ointments applied to insertion sites No No Silver-impregnated subcutaneous collagen-cuffed short-term CVCs No No