Using antiseptic-impregnated catheters reduces the risk of catheter-related
infection, according to a study authored by Dr. Joseph Civetta
in the October 1996 issue of Critical Care Medicine.
In the study, performed at the University of Miami School of Medicine,
Dr. Civetta and his team devised a management protocol of central
venous catheterization. Using ARROWg+ard Blue catheters (Arrow
International, Reading, Pennsylvania), catheters impregnated with
silver sulfadiazine and chlorhexedine, the research team was able
to reduce their trauma intensive care unit rate of catheter-related
infection from 15% to 6%.
In addition to the impact of ARROWg+ard Blue catheters, the indications
for guidewire exchange were also studied. Changes in both the
guidelines and indications for guidewire exchange were implemented.
One change was the substitution of "suspected catheter-related
sepsis" for fever as an indication for exchange. In addition,
the "safe" period (the time before considering changing
of a catheter because catheter-related sepsis was suspected) was
extended from 2 to 4 days. These changes resulted in the elimination
of 40% of guidewire exchanges, associated with a decreased catheter-related
infection rate. Thus, unnecessary changes were eliminated. According
to Dr. Civetta, the increase in the "safe" period of
catheter use was possible due mostly to the use of the antiseptic-impregnated
By using the ARROWg+ard Blue catheters in conjunction with changes
in the guidelines and indications for guidewire exchange, cost
savings were estimated to be $190 per patient and $4,750 per month
to the hospital.