ABSTRACT
Central venous catheters are essential for the care of the critically ill patient. Mechanical and infectious complications are the most common complications associated with central venous catheterization. Antimicrobial catheters appear to be the most efficacious. Use of a chlorhexidine impregnated dressing or sponge also reduced the incidence of high level catheter colonization. Post-hoc analyses of prospective, randomized trials studying the utility of anti-infective catheters indicated the subclavian site of insertion was associated with the lowest risk of infection, followed by the internal jugular and femoral sites. Catheter infection can occur by either bacterial spread via the subcutaneous wound or by the development of an intraluminal biofilm. Alcoholic chlorhexidine was also found to be superior to 10% povidone-iodine in preparing the patient for catheterization. Advances in catheter manufacturing resulted in the development of antimicrobial and antiseptic catheters which were associated with fewer central line associated bloodstream infections compared to control catheters.
