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

Jean-François Timsit^{1

2}, Julien Baleine³, Louis Bernard⁴, Silvia Calvino-Gunther⁵, Michael Darmon⁶, Jean Dellamonica⁷, Eric Desruennes^{8

9}, Marc Leone¹⁰, Alain Lepape^{11

12}, Olivier Leroy^{13

14}, Jean-Christophe Lucet^{15

16}, Zied Merchaoui¹⁷, Olivier Mimoz^{18

19

20}, Benoit Misset²¹, Jean-Jacques Parienti^{22

23}, Jean-Pierre Quenot^{24

25

26}, Antoine Roch^{27

28}, Matthieu Schmidt^{29

30}, Michel Slama³¹, Bertrand Souweine³², Jean-Ralph Zahar^{33

34}, Walter Zingg³⁵, Laetitia Bodet-Contentin³⁶, Virginie Maxime³⁷

Affiliations

¹ APHP/Hopital Bichat-Medical and Infectious Diseases ICU (MI2), 46 rue Henri Huchard, 75018, Paris, France.
² UMR 1137-IAME Team 5-DeSCID: Decision SCiences in Infectious Diseases, Control and Care Inserm/Université de Paris, Sorbonne Paris Cité, 75018, Paris, France.
³ Department of Neonatal Medicine and Pediatric Intensive Care, Arnaud de Villeneuve University Hospital, 371 Avenue Doyen G Giraud, 34295, Montpellier Cedex 5, France.
⁴ Infectious Diseases Unit, University Hospital Tours, Nîmes 2 Boulevard, 37000, Tours, France.
⁵ CHU Grenoble Alpes, Réanimation Médicale Pôle Urgences Médecine Aiguë, 38000, Grenoble, France.
⁶ Medical ICU, Saint-Louis University Hospital, AP-HP, Paris, France.
⁷ Centre Hospitalier Universitaire de Nice, Médecine Intensive Réanimation, Archet 1, UR2CA Unité de Recherche Clinique Côte d'Azur, Université Cote d'Azur, Nice, France.
⁸ Clinique d'anesthésie pédiatrique, Hôpital Jeanne-de-Flandre, avenue Eugène-Avinée, CHU Lille, 59000, Lille, France.
⁹ Unité accès vasculaire, Centre Oscar Lambret, 3 rue Frédéric Combemale, 59000, Lille, France.
¹⁰ Anesthésie Réanimation, Hôpital Nord, 13015, Marseille, France.
¹¹ Service d'Anesthésie et de Réanimation, Hospices Civils de Lyon, Groupement Hospitalier Sud, Lyon, France.
¹² UMR CNRS 5308, Inserm U1111, Laboratoire des Pathogènes Émergents, Centre International de Recherche en Infectiologie, Lyon, France.
¹³ Medical ICU, Chatilliez Hospital, Tourcoing, France.
¹⁴ U934/UMR3215, Institut Curie, PSL Research University, 75005, Paris, France.
¹⁵ AP-HP, Infection Control Unit, Bichat-Claude Bernard University Hospital, 46 rue Henri Huchard, 75877, Paris Cedex, France.
¹⁶ INSERM IAME, U1137, Team DesCID, University of Paris, Paris, France.
¹⁷ Pediatric Intensive Care, Paris South University Hospitals AP-HP, Le Kremlin Bicêtre, France.
¹⁸ Services des Urgences Adultes and SAMU 86, Centre Hospitalier Universitaire de Poitiers, 86021, Poitiers, France.
¹⁹ Université de Poitiers, Poitiers, France.
²⁰ Inserm U1070, Poitiers, France.
²¹ Department of Intensive Care, Sart-Tilman University Hospital, and University of Liège, Liège, Belgium.
²² Department of Biostatistics and Clinical Research and Department of Infectious Diseases, Caen University Hospital, 14000, Caen, France.
²³ EA2656 Groupe de Recherche sur l'Adaptation Microbienne (GRAM 2.0) UNICAEN, CHU Caen Medical School Université Caen Normandie, Caen, France.
²⁴ Department of Intensive Care, François Mitterrand University Hospital, Dijon, France.
²⁵ Lipness Team, INSERM Research Center LNC-UMR1231 and LabExLipSTIC, University of Burgundy, Dijon, France.
²⁶ INSERM CIC 1432, Clinical Epidemiology, University of Burgundy, Dijon, France.
²⁷ Assistance Publique - Hôpitaux de Marseille, Hôpital Nord, Service des Urgences, 13015, Marseille, France.
²⁸ Centre d'Etudes et de Recherches sur les Services de Santé et qualité de vie EA 3279, Faculté de médecine, Aix-Marseille Université, 13005, Marseille, France.
²⁹ Assistance Publique-Hôpitaux de Paris (APHP), Pitié-Salpêtrière Hospital, Medical Intensive Care Unit, 75651, Paris, France.
³⁰ INSERM, UMRS_1166-ICAN, Institute of Cardiometabolism and Nutrition, Pitié-Salpêtrière Hospital, Medical Intensive Care Unit, Sorbonne Universités, 75651, Paris Cedex 13, France.
³¹ Medical Intensive Care Unit, CHU Sud Amiens, Amiens, France.
³² Medical ICU, Gabriel-Montpied University Hospital, Clermont-Ferrand, France.
³³ IAME, UMR 1137, Université Paris 13, Sorbonne Paris Cité, Paris, France.
³⁴ Service de Microbiologie Clinique et Unité de Contrôle et de Prévention Du Risque Infectieux, Groupe Hospitalier Paris Seine Saint-Denis, AP-HP, 125 Rue de Stalingrad, 93000, Bobigny, France.
³⁵ Infection Control Programme and WHO Collaborating Centre on Patient Safety, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland.
³⁶ Medical Intensive Care Unit, INSERM CIC 1415, CRICS-TriGGERSep Network, CHRU de Tours and Université de Tours, Tours, France.
³⁷ Surgical and Medical Intensive Care Unit Hôpital, Raymond Poincaré, 9230, Garches, France. virginie.maxime@aphp.fr.

PMID: 32894389
PMCID: PMC7477021
DOI: 10.1186/s13613-020-00713-4

Review

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

Jean-François Timsit et al. Ann Intensive Care. 2020.

. 2020 Sep 7;10(1):118.

doi: 10.1186/s13613-020-00713-4.

Authors

Affiliations

¹ APHP/Hopital Bichat-Medical and Infectious Diseases ICU (MI2), 46 rue Henri Huchard, 75018, Paris, France.
² UMR 1137-IAME Team 5-DeSCID: Decision SCiences in Infectious Diseases, Control and Care Inserm/Université de Paris, Sorbonne Paris Cité, 75018, Paris, France.
³ Department of Neonatal Medicine and Pediatric Intensive Care, Arnaud de Villeneuve University Hospital, 371 Avenue Doyen G Giraud, 34295, Montpellier Cedex 5, France.
⁴ Infectious Diseases Unit, University Hospital Tours, Nîmes 2 Boulevard, 37000, Tours, France.
⁵ CHU Grenoble Alpes, Réanimation Médicale Pôle Urgences Médecine Aiguë, 38000, Grenoble, France.
⁶ Medical ICU, Saint-Louis University Hospital, AP-HP, Paris, France.
⁷ Centre Hospitalier Universitaire de Nice, Médecine Intensive Réanimation, Archet 1, UR2CA Unité de Recherche Clinique Côte d'Azur, Université Cote d'Azur, Nice, France.
⁸ Clinique d'anesthésie pédiatrique, Hôpital Jeanne-de-Flandre, avenue Eugène-Avinée, CHU Lille, 59000, Lille, France.
⁹ Unité accès vasculaire, Centre Oscar Lambret, 3 rue Frédéric Combemale, 59000, Lille, France.
¹⁰ Anesthésie Réanimation, Hôpital Nord, 13015, Marseille, France.
¹¹ Service d'Anesthésie et de Réanimation, Hospices Civils de Lyon, Groupement Hospitalier Sud, Lyon, France.
¹² UMR CNRS 5308, Inserm U1111, Laboratoire des Pathogènes Émergents, Centre International de Recherche en Infectiologie, Lyon, France.
¹³ Medical ICU, Chatilliez Hospital, Tourcoing, France.
¹⁴ U934/UMR3215, Institut Curie, PSL Research University, 75005, Paris, France.
¹⁵ AP-HP, Infection Control Unit, Bichat-Claude Bernard University Hospital, 46 rue Henri Huchard, 75877, Paris Cedex, France.
¹⁶ INSERM IAME, U1137, Team DesCID, University of Paris, Paris, France.
¹⁷ Pediatric Intensive Care, Paris South University Hospitals AP-HP, Le Kremlin Bicêtre, France.
¹⁸ Services des Urgences Adultes and SAMU 86, Centre Hospitalier Universitaire de Poitiers, 86021, Poitiers, France.
¹⁹ Université de Poitiers, Poitiers, France.
²⁰ Inserm U1070, Poitiers, France.
²¹ Department of Intensive Care, Sart-Tilman University Hospital, and University of Liège, Liège, Belgium.
²² Department of Biostatistics and Clinical Research and Department of Infectious Diseases, Caen University Hospital, 14000, Caen, France.
²³ EA2656 Groupe de Recherche sur l'Adaptation Microbienne (GRAM 2.0) UNICAEN, CHU Caen Medical School Université Caen Normandie, Caen, France.
²⁴ Department of Intensive Care, François Mitterrand University Hospital, Dijon, France.
²⁵ Lipness Team, INSERM Research Center LNC-UMR1231 and LabExLipSTIC, University of Burgundy, Dijon, France.
²⁶ INSERM CIC 1432, Clinical Epidemiology, University of Burgundy, Dijon, France.
²⁷ Assistance Publique - Hôpitaux de Marseille, Hôpital Nord, Service des Urgences, 13015, Marseille, France.
²⁸ Centre d'Etudes et de Recherches sur les Services de Santé et qualité de vie EA 3279, Faculté de médecine, Aix-Marseille Université, 13005, Marseille, France.
²⁹ Assistance Publique-Hôpitaux de Paris (APHP), Pitié-Salpêtrière Hospital, Medical Intensive Care Unit, 75651, Paris, France.
³⁰ INSERM, UMRS_1166-ICAN, Institute of Cardiometabolism and Nutrition, Pitié-Salpêtrière Hospital, Medical Intensive Care Unit, Sorbonne Universités, 75651, Paris Cedex 13, France.
³¹ Medical Intensive Care Unit, CHU Sud Amiens, Amiens, France.
³² Medical ICU, Gabriel-Montpied University Hospital, Clermont-Ferrand, France.
³³ IAME, UMR 1137, Université Paris 13, Sorbonne Paris Cité, Paris, France.
³⁴ Service de Microbiologie Clinique et Unité de Contrôle et de Prévention Du Risque Infectieux, Groupe Hospitalier Paris Seine Saint-Denis, AP-HP, 125 Rue de Stalingrad, 93000, Bobigny, France.
³⁵ Infection Control Programme and WHO Collaborating Centre on Patient Safety, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland.
³⁶ Medical Intensive Care Unit, INSERM CIC 1415, CRICS-TriGGERSep Network, CHRU de Tours and Université de Tours, Tours, France.
³⁷ Surgical and Medical Intensive Care Unit Hôpital, Raymond Poincaré, 9230, Garches, France. virginie.maxime@aphp.fr.

PMID: 32894389
PMCID: PMC7477021
DOI: 10.1186/s13613-020-00713-4

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.

Keywords: Bacteremia; Catheter; Critically ill; Infection; Prevention; Sepsis.

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Conflict of interest statement

JFT: Research Grant from 3M, Astelas, Merck, Pfizer, Biomerieux to my university. Lectures in symposium:3M, Merck, Biomerieux, Novartis, Pfizer, Gilead. Participation to scientific board: Merck, 3M, Pfizer, Nabriva, Bayer Pharma, Gilead.

MD: Grant from MSD, lecture for MSD, Astellas, Gilead and participation to meeting from Gilead.

ML: Lectures for 3M, Aspen, BioMerieux, MSD, Octopharma, Orion, Pfizer; Consulting for Amomed, Aguettant; Travel expense: LFB.

AL: consulting for Fresenius. Lecture in symposium: Pfizer.

OM: Grant and lecture for BD, 3M.

MSc: lecture for Getinge, 3M, Drager.

BS: lecture for MSD. Participation to medical meeting for Gilead, Bard; IDSA meeting for Sanofi.

JRZ: Grant from MDS, lecture for MSD, EUMEDICA, Pfizer, Correvio.

The remaining authors declare no conflict of interest.

References

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

Affiliations

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

Authors

Affiliations

Abstract

Conflict of interest statement

References

Publication types

LinkOut - more resources

Full Text Sources

Medical