Abstract
The study compares the incidence of infectious and mechanical complications associated with different maintenance protocols for central venous neck catheters. Patients were randomly assigned to either prophylactic catheter change or change for clinical reasons (PRN). Four groups resulted from additional grouping on the basis of guide-wire or new venipuncture change. The prophylactic change was scheduled at 3-day intervals. Clinical indications for PRN included unexplained fever, exit site infection, or catheter malfunction. One hundred sixty patients were randomized and had 523 catheters placed. There was a 5% catheter-related bloodstream infection rate and a 9% significant mechanical complication rate. Insertion by a new puncture had a greater incidence of mechanical complications (p < .005). The infectious complication rate was not decreased with routine change either by new venipuncture or guide wire and was lowest with PRN change by a new venipuncture.
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