Bacterial colonisation of midline and central venous catheters

Excerpt

The provision of parenteral nutrition conventionally requires the insertion of a central venous catheter (CVC) with the attendant risks of pneumothorax, vascular damage and line sepsis [1]. In addition, CVC insertion requires appropriately trained medical staff. It is possible to provide central venous access with peripherally inserted central catheters (PICC) but these are associated with malposition, catheter fracture, leakage and occlusion [2]. An alternative to these is the use of 20 cm single lumen 22 G venous catheters inserted in the antecubital fossa (midlines). This unit provides a 'midline' service for parental nutrition or long-term venous access, and this audit describes the experience of this service to date. All lines were inserted on a general ward by a trained theatre technician using standard sterile techniques including chlorhexidine or iodine (in 70% methylated spirit) skin preparation and a semipermeable film dressing (tegaderm™). At removal, midline tips were sent for microbiological analysis using a Maki roll technique. …