[Femoral venous catheterization. Does it really need to be avoided?].
The guidelines to prevent central venous catheter related bloodstream infections (CVCBSI) of the Centers for Disease Control and Prevention (CDC) of 2002, Sociedad Española de Medicina Intensiva, Crítica y Unidades Coronarias/ Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica (SEMICYUC/SEIMC) of 2004, and the recently published guidelines of the Society for Healthcare Epidemiology of America/Infectious Diseases Society of America (SHEA(IDSA) of 2008 have recommended using the subclavian vein and avoiding the use of the femoral vein. They also recommend considering the use of antiseptic- or antimicrobial-impregnated CVCs for hospital units or groups of patients with a high incidence of CVCBSI. When implementing these guidelines, two questions could be asked: 1) Could the abuse of the subclavian vein and avoiding the use of the femoral vein imply a decrease in the incidence of CVCBSI, but an increase in the rate of mechanical complications as pneumothorax and/or hemothorax? 2) Couldn't antimicrobial-impregnated CVCs be used to prevent CVCBSI when the femoral venous access is used?
Lorente
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L
Unidad de Cuidados Intensivos, Hospital Universitario de Canarias, La Laguna, Tenerife, España. lorentemartin@msn.com
León
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C
D000890:Anti-Infective Agents / Q000008:administration & dosage; D000891:Anti-Infective Agents, Local / Q000008:administration & dosage; D001158:Arteries / Q000293:injuries; D016470:Bacteremia / Q000209:etiology / Q000517:prevention & control; D055499:Catheter-Related Infections / Q000209:etiology / Q000517:prevention & control; D002405:Catheterization, Central Venous / Q000009:adverse effects / Q000379:methods; D000075202:Contraindications; D005268:Femoral Vein; D006491:Hemothorax / Q000209:etiology; D006801:Humans; D011030:Pneumothorax / Q000209:etiology; D017410:Practice Guidelines as Topic; D012306:Risk; D013030:Spain; D013314:Stress, Mechanical; D013350:Subclavian Vein; D019564:Unnecessary Procedures; D020246:Venous Thrombosis / Q000209:etiology
D000890:Anti-Infective Agents; D000891:Anti-Infective Agents, Local