Central venous catheter practice in an adult intensive care setting in the eastern province of Saudi Arabia

ABSTRACT

To study the standard central venous catheter [CVC] practice in an adult intensive care unit [ICU] for potential improvement. This is a prospective descriptive study conducted in an adult ICU of the 300-bedded King Abdul- Aziz Hospital, Al Ahsa, Saudi Arabia. All consecutive patients admitted over 18 months [April 2007 to September 2008] were included. Details of CVCs, indications, complications, and patients' demographic information were recorded daily until CVCs were removed. Overall, 379 patients had 474 CVCs, which accounted for 3024 catheter-days, with a mean duration of 6.35 +/- 4.7 days [95% confidence intervals 5.92-6.78]. The most common site of insertion was the internal jugular vein [230 [48.5%]]; 192 [40.5%] subclavian catheters, and 52 [11%] femoral. The CVC utilization ratio was 0.64. The catheter related local infection [CRLI] rate was 4.6 per 1000 catheter-day [the highest in the femoral site] and the catheter-related bloodstream infection [CRBSI] rate was 1.98 per 1000 catheter-day [the highest for the jugular route]. There were only a few mechanical complications including 2 pneumothoraces, 5 arterial cannulations, and a single significant catheter dislodgement causing respiratory failure. Our results suggest that the current CVC practice enabled us to keep the rate of complications low, which is comparable to international standards