Abstract
Objective: We changed the preventive measures against infections in our ICU according to the revised Guidelines for the Prevention of the Intravascular Catheter-Related infections in 2002. The main changes about the use of central venous catheters (CVC) were the adoption of maximal barrier precautions at the time of insertion and discontinuation of scheduled catheter replacement (every 10 days). We investigated the change in the incidence of catheter-related infections and other complications following the introduction of these changes. Methods: We conducted a retrospective review of the data of patients who underwent CVC insertion before the introduction of the changes (Gruop A; n=80) and after the introduction of the changes (Group B; n=73) at our ICU between July 2002 and July 2003. Results: No significant differences were noted between Group A and Group B in the diagnoses on admission, the initial Acute Physiology and Chronic Health Evaluation II scores (APACHE II scores), age, sex, or distribution of the sites of insertion of CVC. There was also no significant difference in the duration of the catheter use between the two groups. There was one case of catheter-related infection and a mechanical complication in both the groups. Neither difficulty in achieving hemostasis nor thrombus formation was noted in either group at the time of withdrawal of the catheter in cases requiring prolonged catheterization. Conclusions: Adoption of the revised guidelines of the Centers for Disease Control and Prevention (CDC), including discontinuation of the regular replacement of CVCs, was not associated with any increase in the incidence of catheter-related infections, or any changes in the incidence of other complications.
