Casey Anna L, Elliott Tom S J
Department of Clinical Microbiology and Infection Control, University Hospitals Birmingham NHS Foundation Trust, The Queen Elizabeth Hospital, Edgbaston, Birmingham.
Br J Nurs. 2010;19(2):78, 80, 82 passim. doi: 10.12968/bjon.2010.19.2.46289.
Central venous catheters (CVCs) are an essential part of modern-day healthcare, but infections associated with these devices continue to cause significant morbidity and mortality. There are many approaches for the prevention of CVC-related infection and these are outlined in national guidelines. The Department of Health Saving Lives campaign has developed a care-bundle for the prevention of CVC-related infections that focuses on the fundamental actions to be undertaken during the catheter insertion process and ongoing care. If the rate of catheter-related infection remains high despite the implementation of these infection prevention strategies, the use of novel antimicrobial technologies and practices may be considered. These include CVCs that contain antimicrobial agents, such as antiseptics or antibiotics, needleless intravenous (IV) access devices coated with silver and/or chlorhexidine, IV dressings incorporating chlorhexidine, and the use of antimicrobial catheter lock solutions, such as antibiotics, chelators or ethanol. This article outlines the different types of CVCs available, the risk of infection associated with their use and established and novel measures for prevention of these infections.
中心静脉导管(CVCs)是现代医疗保健的重要组成部分,但与这些装置相关的感染继续导致显著的发病率和死亡率。预防CVC相关感染有许多方法,国家指南中对此进行了概述。卫生部“拯救生命”运动制定了一套预防CVC相关感染的护理包,重点关注在导管插入过程和持续护理期间应采取的基本措施。如果尽管实施了这些感染预防策略,导管相关感染率仍然很高,则可以考虑使用新型抗菌技术和做法。这些包括含有抗菌剂(如防腐剂或抗生素)的CVC、涂有银和/或洗必泰的无针静脉(IV)接入装置、含有洗必泰的IV敷料,以及使用抗菌导管封管溶液(如抗生素、螯合剂或乙醇)。本文概述了可用的不同类型的CVC、与使用它们相关的感染风险以及预防这些感染的既定措施和新措施。