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Expert consensus-based clinical practice guidelines management of intravascular catheters in the intensive care unit

Authors
  • Timsit, Jean-François1, 2
  • Baleine, Julien3
  • Bernard, Louis4
  • Calvino-Gunther, Silvia5
  • Darmon, Michael6
  • Dellamonica, Jean7
  • Desruennes, Eric8, 9
  • Leone, Marc10
  • Lepape, Alain11, 12
  • Leroy, Olivier13, 14
  • Lucet, Jean-Christophe15, 16
  • Merchaoui, Zied17
  • Mimoz, Olivier18, 19, 20
  • Misset, Benoit21
  • Parienti, Jean-Jacques22, 23
  • Quenot, Jean-Pierre24, 25, 25
  • Roch, Antoine26, 27
  • Schmidt, Matthieu28, 29
  • Slama, Michel30
  • Souweine, Bertrand31
  • And 4 more
  • 1 APHP/Hopital Bichat-Medical and Infectious Diseases ICU (MI2), 46 rue Henri Huchard, Paris, 75018, France , Paris (France)
  • 2 Sorbonne Paris Cité, Paris, 75018, France , Paris (France)
  • 3 Arnaud de Villeneuve University Hospital, 371 Avenue Doyen G Giraud, Montpellier Cedex 5, 34295, France , Montpellier Cedex 5 (France)
  • 4 University Hospital Tours, Nîmes 2 Boulevard, Tours, 37000, France , Tours (France)
  • 5 Réanimation Médicale Pôle Urgences Médecine Aiguë, Grenoble, 38000, France , Grenoble (France)
  • 6 Saint-Louis University Hospital, AP-HP, Paris, France , Paris (France)
  • 7 Université Cote d’Azur, Nice, France , Nice (France)
  • 8 Clinique d’anesthésie pédiatrique, Hôpital Jeanne-de-Flandre, avenue Eugène-Avinée, CHU Lille, Lille, 59000, France , Lille (France)
  • 9 Centre Oscar Lambret, 3 rue Frédéric Combemale, Lille, 59000, France , Lille (France)
  • 10 Hôpital Nord, Marseille, 13015, France , Marseille (France)
  • 11 Hospices Civils de Lyon, Groupement Hospitalier Sud, Lyon, France , Lyon (France)
  • 12 Centre International de Recherche en Infectiologie, Lyon, France , Lyon (France)
  • 13 Chatilliez Hospital, Tourcoing, France , Tourcoing (France)
  • 14 PSL Research University, Paris, 75005, France , Paris (France)
  • 15 Bichat-Claude Bernard University Hospital, 46 rue Henri Huchard, Paris Cedex, 75877, France , Paris Cedex (France)
  • 16 University of Paris, Paris, France , Paris (France)
  • 17 Paris South University Hospitals AP-HP, Le Kremlin Bicêtre, France , Le Kremlin Bicêtre (France)
  • 18 Centre Hospitalier Universitaire de Poitiers, Poitiers, 86021, France , Poitiers (France)
  • 19 Université de Poitiers, Poitiers, France , Poitiers (France)
  • 20 Inserm U1070, Poitiers, France , Poitiers (France)
  • 21 Sart-Tilman University Hospital, and University of Liège, Liège, Belgium , Liège (Belgium)
  • 22 Caen University Hospital, Caen, 14000, France , Caen (France)
  • 23 CHU Caen Medical School Université Caen Normandie, Caen, France , Caen (France)
  • 24 François Mitterrand University Hospital, Dijon, France , Dijon (France)
  • 25 University of Burgundy, Dijon, France , Dijon (France)
  • 26 Assistance Publique - Hôpitaux de Marseille, Hôpital Nord, Service des Urgences, Marseille, 13015, France , Marseille (France)
  • 27 Aix-Marseille Université, Marseille, 13005, France , Marseille (France)
  • 28 Medical Intensive Care Unit, Paris, 75651, France , Paris (France)
  • 29 Sorbonne Universités, Paris Cedex 13, 75651, France , Paris Cedex 13 (France)
  • 30 Medical Intensive Care Unit, CHU Sud Amiens, Amiens, France , Amiens (France)
  • 31 Gabriel-Montpied University Hospital, Clermont-Ferrand, France , Clermont-Ferrand (France)
  • 32 Sorbonne Paris Cité, Paris, France , Paris (France)
  • 33 Groupe Hospitalier Paris Seine Saint-Denis, AP-HP, 125 Rue de Stalingrad, Bobigny, 93000, France , Bobigny (France)
  • 34 University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland , Geneva (Switzerland)
  • 35 CHRU de Tours and Université de Tours, Tours, France , Tours (France)
  • 36 Surgical and Medical Intensive Care Unit Hôpital, Raymond Poincaré, Garches, 9230, France , Garches (France)
Type
Published Article
Journal
Annals of Intensive Care
Publisher
Springer (Biomed Central Ltd.)
Publication Date
Sep 07, 2020
Volume
10
Issue
1
Identifiers
DOI: 10.1186/s13613-020-00713-4
Source
Springer Nature
Keywords
License
Green

Abstract

The French Society of Intensive Care Medicine (SRLF), jointly with the French-Speaking Group of Paediatric Emergency Rooms and Intensive Care Units (GFRUP) and the French-Speaking Association of Paediatric Surgical Intensivists (ADARPEF), worked out guidelines for the management of central venous catheters (CVC), arterial catheters and dialysis catheters in intensive care unit. For adult patients: Using GRADE methodology, 36 recommendations for an improved catheter management were produced by the 22 experts. Recommendations regarding catheter-related infections’ prevention included the preferential use of subclavian central vein (GRADE 1), a one-step skin disinfection(GRADE 1) using 2% chlorhexidine (CHG)-alcohol (GRADE 1), and the implementation of a quality of care improvement program. Antiseptic- or antibiotic-impregnated CVC should likely not be used (GRADE 2, for children and adults). Catheter dressings should likely not be changed before the 7th day, except when the dressing gets detached, soiled or impregnated with blood (GRADE 2− adults). CHG dressings should likely be used (GRADE 2+). For adults and children, ultrasound guidance should be used to reduce mechanical complications in case of internal jugular access (GRADE 1), subclavian access (Grade 2) and femoral venous, arterial radial and femoral access (Expert opinion). For children, an ultrasound-guided supraclavicular approach of the brachiocephalic vein was recommended to reduce the number of attempts for cannulation and mechanical complications. Based on scarce publications on diagnostic and therapeutic strategies and on their experience (expert opinion), the panel proposed definitions, and therapeutic strategies.

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