Zingg Walter, Barton Andrew, Bitmead James, Eggimann Philippe, Pujol Miquel, Simon Arne, Tatzel Johannes
Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, Zurich, Switzerland.
Frimley Health NHS Foundation Trust, Frimley, United Kingdom.
Infect Prev Pract. 2023 Feb 3;5(2):100271. doi: 10.1016/j.infpip.2023.100271. eCollection 2023 Jun.
Peripheral intravenous catheters (PIVCs) are the most commonly used invasive medical device in health care with an overall failure rate of 35-50%. Most complications are non-infectious, but local site and bloodstream infections can also occur. Even if PIVC-related infections are rare, the total number of affected patients and the preponderance of as related pathogen due to the frequent use of these devices are relevant arguments to implement preventive strategies. The aim of this document is to raise awareness that infections caused by PIVCs are a relevant problem that can be reduced by practice change.
A panel of experts discussed this topic based on evidence and proposed practice points by consensus.
Despite published evidence-based guidelines, current practice concerning aseptic techniques during insertion and care of PIVCs often are substandard. These devices have become commonplace and tend to be perceived as safe. An overall lack of awareness about the true risks associated with the use of PIVCs results in limited surveillance and prevention efforts.
Successful insertion and maintenance bundles in central venous lines are a blueprint to the implementation of adapted bundle strategies in the prevention of PIVC-associated infections. There is a need for studies to specifically investigate infection prevention in PIVCs and to agree on effective and implementable bundles.
外周静脉导管(PIVC)是医疗保健中最常用的侵入性医疗器械,总体故障率为35%-50%。大多数并发症是非感染性的,但局部部位和血流感染也可能发生。即使与PIVC相关的感染很少见,但由于这些器械的频繁使用,受影响患者的总数以及相关病原体的优势也是实施预防策略的相关依据。本文档的目的是提高人们的认识,即PIVC引起的感染是一个相关问题,可以通过改变实践来减少。
一个专家小组根据证据讨论了这个话题,并通过共识提出了实践要点。
尽管有已发表的循证指南,但目前在PIVC插入和护理过程中有关无菌技术的实践往往不达标。这些器械已变得很常见,并且往往被认为是安全的。对与使用PIVC相关的真正风险普遍缺乏认识,导致监测和预防工作有限。
中心静脉导管成功的插入和维护集束是在预防与PIVC相关感染中实施适应性集束策略的蓝本。需要进行专门研究PIVC感染预防的研究,并就有效且可实施的集束达成一致。