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Annals of Intensive Care
Published in: Annals of Intensive Care 1/2020

Open Access 01-12-2020 | Antibiotic | Review

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

Authors: Jean-François Timsit, Julien Baleine, Louis Bernard, Silvia Calvino-Gunther, Michael Darmon, Jean Dellamonica, Eric Desruennes, Marc Leone, Alain Lepape, Olivier Leroy, Jean-Christophe Lucet, Zied Merchaoui, Olivier Mimoz, Benoit Misset, Jean-Jacques Parienti, Jean-Pierre Quenot, Antoine Roch, Matthieu Schmidt, Michel Slama, Bertrand Souweine, Jean-Ralph Zahar, Walter Zingg, Laetitia Bodet-Contentin, Virginie Maxime

Published in: Annals of Intensive Care | Issue 1/2020

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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.
Appendix
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Metadata
Title
Expert consensus-based clinical practice guidelines management of intravascular catheters in the intensive care unit
Authors
Jean-François Timsit
Julien Baleine
Louis Bernard
Silvia Calvino-Gunther
Michael Darmon
Jean Dellamonica
Eric Desruennes
Marc Leone
Alain Lepape
Olivier Leroy
Jean-Christophe Lucet
Zied Merchaoui
Olivier Mimoz
Benoit Misset
Jean-Jacques Parienti
Jean-Pierre Quenot
Antoine Roch
Matthieu Schmidt
Michel Slama
Bertrand Souweine
Jean-Ralph Zahar
Walter Zingg
Laetitia Bodet-Contentin
Virginie Maxime
Publication date
01-12-2020
Publisher
Springer International Publishing
Published in
Annals of Intensive Care / Issue 1/2020
Electronic ISSN: 2110-5820
DOI
https://doi.org/10.1186/s13613-020-00713-4

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