Prevention of infections associated with intravascular devices

Intravascular catheters have become indispensable and essential in the care of critically ill patients. However, the morbidity and mortality that result from vascular catheter-related infections and the high cost of managing such complications may offset the benefits derived from these devices. Several measures have been used to successfully prevent vascular catheter-related infection. These measures include the placement and maintenance of vascular catheters by a skilled infusion therapy team, the use of maximal sterile barriers during catheter insertion, the application of such topical disinfectants as chlorhexidine, the use of silver-impregnated subcutaneous cuffs (for the short-term use of central venous catheters), the practice of flushing catheters with a combination of antimicrobial and antithrombotic agents, the new hub model, and the antimicrobial coating of catheters with antiseptic (chlorhexidine and silver sulfadiazine) or antibiotic agents (minocycline and rifampin).