Central venous catheters: care and preventing complications principals of Health Care-Associated Infections

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Abstract

Rationale. Central venous catheters (CVC) are widely used to administer medications and solutions and to obtain blood samples in hospitalized patients. The use of CVC is associated with vascular complications, the most dangerous of which is catheter-associated bloodstream infection. The severity of complications of central venous catheters, risks to health and life of patients, and the cost of treatment for catheter-related bacteremia constitute a big problem for patients, medical and administrative staff of healthcare facilities. The prevention of catheter-related complications should be an important part of daily clinical practice; this process is to be managed and monitored by hospital administrative staff.

The article is a literature review of modern recommendations with regulatory documents of the Russian Federation regarding CVC care and catheter-related complications prevention. The article describes the key aspects of CVC maintenance: the improvement of manual skills of medical personnel; ensuring the sterility, closed-hub catheter system and integrity of the venous catheter; catheter insertion site care rules to ensure its sterility; ways of maintaining the patency of the inner lumen of the catheter using the rules of bolus insertion, catheter flushing and catheter locking. The epidemiological safety of medical personnel allowed to work with the CVC and the criteria for infection control over all processes are of great importance..

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About the authors

Dilya Sh. Bikkulova

Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology of Ministry of Healthcare of the Russian Federation; Pirogov Russian National Research Medical University

Author for correspondence.
Email: bikkul@mail.ru
ORCID iD: 0000-0001-7741-1113

anesthesiologist, Doctor of Medicine, Chief Researcher, Professor

Russian Federation,

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2. Pic. 1. The needle-free connection device BD Q-Syte (FPS 2009/05473) is treated a medical napkin with an antiseptic solution before operation of the catheter.

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3. Pic. 2. The Peripherally inserted central venous catheter PowerPICC Solo2 (РЗН 2016/4148) is fixed to skin by a seamless fixation device StatLock (РЗН 2015/3330), catheter is closed by chlorhexidine gluconate I.V. securement dressing

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4. Pic. 3. Initial state of catheters before flushing

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5. Pic. 4. Flushing of two catheter have been of continuous and pulsed technique: the effect of laminar and turbulent fluid flow

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