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

Jean-François Timsit; Julien Baleine; Louis Bernard; Silvia Calvino-Gunther; Michael Darmon; Jean Dellamonica; Eric Desruennes; Marc Leone; Alain Lepape; Olivier Leroy; Jean-Christophe Lucet; Zied Merchaoui; Olivier Mimoz; Benoit Misset; Jean-Jacques Parienti; Jean-Pierre Quenot; Antoine Roch; Matthieu Schmidt; Michel Slama; Bertrand Souweine; Jean-Ralph Zahar; Walter Zingg; Laetitia Bodet-Contentin; Virginie Maxime

doi:10.1186/s13613-020-00713-4

Journal articles

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

Jean-François Timsit ^{1, 2} Julien Baleine ³ Louis Bernard ⁴ Silvia Calvino-Gunther ⁵ Michael Darmon ⁶ Jean Dellamonica ⁷ Eric Desruennes ^{8, 9} Marc Leone ¹⁰ Alain Lepape ^{11, 12} Olivier Leroy ¹³ Jean-Christophe Lucet ^{14, 2} Zied Merchaoui ¹⁵ Olivier Mimoz ^{16, 17} Benoit Misset ¹⁸ Jean-Jacques Parienti ^{19, 20} Jean-Pierre Quenot ^{21, 22, 23} Antoine Roch ^{24, 10} Matthieu Schmidt ²⁵ Michel Slama ²⁶ Bertrand Souweine ²⁷ Jean-Ralph Zahar ² Walter Zingg ²⁸ Laetitia Bodet-Contentin ²⁹ Virginie Maxime ³⁰

1 MI2 - Inflammation, microbiome, immunosurveillance

2 IAME (UMR_S_1137 / U1137) - Infection, Anti-microbiens, Modélisation, Evolution

3 Hôpital Arnaud de Villeneuve [CHRU Montpellier]

4 CHRU TOURS - Centre Hospitalier Régional Universitaire de Tours

5 CHU - Centre Hospitalier Universitaire [Grenoble]

6 CHU Saint Louis [APHP]

7 CHU Nice - Centre Hospitalier Universitaire de Nice

8 Hôpital Jeanne de Flandres

9 UNICANCER/Lille - Centre Régional de Lutte contre le Cancer Oscar Lambret [Lille]

10 Hôpital Nord [CHU - APHM]

11 CIRI - Centre International de Recherche en Infectiologie - UMR

12 HCL - Hospices Civils de Lyon

13 Génétique et Biologie du Développement

14 CIC - CHU Bichat

15 AP-HP Hôpital Bicêtre (Le Kremlin-Bicêtre)

16 CHU Poitiers - Centre hospitalier universitaire de Poitiers

17 PHAR - Pharmacologie des anti-infectieux

18 Université de Liège

19 CHU Caen

20 GRAM 2.0 - Groupe de Recherche sur l'Adaptation Microbienne

21 LNC - Lipides - Nutrition - Cancer [Dijon - U1231]

22 LabEx LipSTIC - Laboratoire d'Excellence : Lipoprotéines et Santé : prévention et Traitement des maladies Inflammatoires et du Cancer

23 CIC-EC - Centre d'Investigation Clinique 1432 (Dijon) - Epidemiologie Clinique/Essais Cliniques

24 CEReSS - Centre d'études et de recherche sur les services de santé et la qualité de vie

25 ICAN - Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Institute of cardiometabolism and nutrition

26 CHU Amiens-Picardie

27 CHU - CHU Gabriel Montpied

28 CHUV - Centre Hospitalier Universitaire Vaudois [Lausanne]

29 CIC - Centre d’Investigation Clinique [Tours]

30 Hôpital Raymond Poincaré [AP-HP]

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

Document type :

Journal articles

Domain :

Life Sciences [q-bio]

Complete list of metadatas

https://hal.sorbonne-universite.fr/hal-03105706
Contributor : Gestionnaire Hal-Su <>
Submitted on : Monday, January 11, 2021 - 11:34:50 AM
Last modification on : Thursday, January 21, 2021 - 2:10:04 PM

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