Navigating Central Venous Catheter Care: Insights from a Comprehensive Review

Central venous catheters (CVCs) are indispensable in healthcare, but they also present a spectrum of potential complications. With the rapid influx of securement and dressing products over the past decade, assessing their overall effectiveness in preventing these complications has become paramount. A recent systematic review with meta-analysis aimed to compare the effects of various dressings and securement devices for CVCs, shedding light on critical considerations for clinicians.

Study Overview

The study delved into 46 randomized controlled trials involving 10,054 participants, evaluating the efficacy of different dressing and securement devices for CVCs. Complications assessed included catheter-related bloodstream infections, catheter tip colonization, entry/exit-site infections, skin colonizations, skin irritations, failed catheter securements, dressing durability, and mortality.

Key Findings

Effectiveness of Dressings: Chlorhexidine gluconate-impregnated dressings showed potential in reducing catheter-related bloodstream infections and catheter tip colonization compared to standard polyurethane dressings. Medication-impregnated dressings also exhibited a reduction in catheter-related bloodstream infections and catheter tip colonization.
Securement Devices: Tissue adhesive, while enhancing dressing durability, also increased the risk of skin irritation or damage and failed catheter securements compared to other securement methods.

Conclusion and Practice Implications

The findings offer valuable insights for clinicians grappling with CVC care. Choosing the appropriate dressing and securement device can significantly impact patient outcomes, particularly in preventing catheter-related infections and ensuring secure catheter placement. However, caution is advised due to heterogeneity in catheter types and patient populations.

Moving Forward

As healthcare evolves, ongoing research and evidence-based practices will continue to refine CVC care protocols. Clinicians are encouraged to stay updated with the latest findings and tailor their approaches to individual patient needs, ultimately enhancing the quality and safety of CVC management.

Read More: https://pubmed.ncbi.nlm.nih.gov/37879273/ 

Authors: Hui Xu, Areum Hyun, Gabor Mihala, Claire M Rickard, Marie L Cooke, Frances Lin, Marion Mitchell, Amanda J Ullman