PREVENCIÓN Y CONTROL DE INFECCIONES RELACIONADAS CON EL MANEJO DEL CATÉTER ARTERIAL PERIFÉRICO

Pereira, Vitória Helena; Cruz, Maria Cristina Mendes de Almeida; Galon, Tanyse; Januário, Gabriela da Cunha; Contim, Divanice; Santos, Mariana Alvina dos; Monteiro, Damiana Aparecida Trindade; Toffano, Silmara Elaine Malaguti

doi:10.1590/1980-265X-TCE-2023-0208en

person Vitória Helena Pereira

Study design · Data collection · Data analysis and interpretation · Discussion of results · Writing and/or critical review of content · Review and final approval of the final version

schoolUniversidade Federal do Triângulo Mineiro, Programa de Pós-Graduação Stricto Sensu em Atenção à Saúde. Uberaba, Minas Gerais, Brasil.

0000-0002-6651-8254

person Maria Cristina Mendes de Almeida Cruz

Discussion of results · Writing and/or critical review of content · Review and final approval of the final version

schoolUniversidade de São Paulo, Escola de Enfermagem de Ribeirão Preto. Ribeirão Preto, São Paulo, Brasil.

0000-0003-2615-3390

person Tanyse Galon

Discussion of results · Writing and/or critical review of content · Review and final approval of the final version

schoolUniversidade Federal do Triângulo Mineiro, Departamento de Enfermagem na Assistência Hospitalar. Uberaba, Minas Gerais, Brasil.

0000-0001-6407-5739

person Gabriela da Cunha Januário

Data analysis and interpretation · Discussion of results · Writing and/or critical review of content · Review and final approval of the final version

schoolUniversidade Federal do Triângulo Mineiro, Programa de Pós-Graduação Stricto Sensu em Atenção à Saúde. Uberaba, Minas Gerais, Brasil.

0000-0002-3585-0705

person Divanice Contim

Discussion of results · Writing and/or critical review of content · Review and final approval of the final version

schoolUniversidade Federal do Triângulo Mineiro, Departamento de Enfermagem na Assistência Hospitalar. Uberaba, Minas Gerais, Brasil.

0000-0001-5213-1465

person Mariana Alvina dos Santos

Discussion of results · Writing and/or critical review of content · Review and final approval of the final version

schoolUniversidade Federal do Mato Grosso do Sul. Três Lagoas, Mato Grosso do Sul, Brasil.

0000-0002-7940-6673

person Damiana Aparecida Trindade Monteiro

Writing and/or critical review of content · Review and final approval of the final version

schoolUniversidade Federal do Triângulo Mineiro, Programa de Pós-Graduação Stricto Sensu em Atenção à Saúde. Uberaba, Minas Gerais, Brasil.

0000-0002-6740-7687

person Silmara Elaine Malaguti Toffano

Study design · Data collection · Data analysis and interpretation · Discussion of results · Writing and/or critical review of content · Review and final approval of the final version

schoolUniversidade Federal do Triângulo Mineiro, Departamento de Enfermagem na Assistência Hospitalar. Uberaba, Minas Gerais, Brasil.

0000-0002-9080-9123

personCORRESPONDING AUTHOR Vitória Helena Pereira
vitoria.hp95@gmail.com

CONFLICT OF INTEREST

There is no conflict of interest.

EDITORS

Associated Editors: Gisele Cristina Manfrini, Ana Izabel Jatobá de Souza. Editor-in-chief: Elisiane Lorenzini.

ID* LoE^† place and date	Design	Objective	Approach
O’Grady et al.¹⁷ LoE^†: VII USA/2002	Review, guideline	To create a guideline for the prevention of infections related to intravascular catheters.	Hand hygiene.
Maki, Crnich¹⁸ LoE^†: VII USA/2003	Review	To identify the risks of healthcare-related infections caused by catheters in intensive care.	Skin antisepsis.
Cousins, O’Donnel¹⁹ LoE^†: V USA/2004	Review	To examine the radial, brachial, axillary and femoral arterial puncture sites.	Puncture site.
Koh et al.²⁰ LoE^†: VI Australia/ 2008	Descriptive, quantitative, observational	To measure colonization and rates of catheter-related bloodstream infection in arterial catheters.	The choice of the radial artery without specifying which side of the limb. Infection rate.
Martins et al.²¹ LoE^†: VI Brazil/2008	Descriptive, observational	To verify nursing professionals adherence to asepsis recommendations when installing and handling the PVC**.	Skin antisepsis.
Small et al.²² LoE^†: II United Kingdom/2008	Randomized clinical trial	To compare the effectiveness of 2% chlorhexidine gluconate in 70% isopropyl alcohol and 70% isopropyl alcohol for skin disinfection to prevent catheter-related healthcare-related infections.	Skin antisepsis.
Lee et al.²³ LoE^†: II Taiwan/2009	Randomized clinical trial	To examine whether the scheduled change interval from 48 to 72 hours to 72 to 96 hours is a risk factor for PVC** infection.	Skin antisepsis.
López et al.²⁴ LoE^†: II Spain/2009	Randomized clinical trial	To investigate the clinical performance of a closed infusion system compared to an open system in PVC**.	For skin antisepsis, 70% alcohol.
Lemaster et al.²⁵ LoE^†: V USA/2010	Systematic review	To carry out a systematic review of CVC^§ and PAC^‡‡ studies inserted in emergencies.	Invasive line in emergency sectors and maximum barrier precautions.
Koh et al.²⁶ LoE^†: IV Australia/2012	Descriptive, quantitative, prospective and observational	To determine catheter colonization rates after removal.	Skin antisepsis, maximum sterile barrier, sterile drape and glove.
Vezzani et al.²⁷ LoE^†: VI Italy/2013	Descriptive, prospective, observational, review	To use ultrasound as a guide during vascular access procedures.	Ultrasound use, Allen test.
López et al.²⁸ LoE^†: II Spain/2014	Randomized clinical trial	To compare closed system PVC with open system PVC.	Skin antisepsis.
Calero et al. ²⁹ LoE^†: V Spain/2015	Systematic review	To establish which antiseptic solution is most suitable for skin antisepsis to prevent healthcare-related infections caused by catheter use.	Skin antisepsis.
Melo, et al.³⁰ LoE^†: VI Brazil/2015	Descriptive	To analyze the care provided by nursing professionals during peripheral venipuncture.	Skin antisepsis.
Choudhury et al.³¹ LoE^†: II Australia/2016	Randomized clinical trial	To determine bacterial community structures in the skin at insertion sites and associated PVC**.	Skin antisepsis.
Evans et al.³² LoE^†: IV Australia/2016	Descriptive, quantitative, comparative	To assess the sensitivity, specificity and accuracy of two in situ diagnostic methods for healthcare-related infection prevention related to catheter use in adults hospitalized for burns.	Skin antisepsis, sterile technique, maximum protection barriers, ultrasound use.
Kiefer, Keller, Weekes³³ LoE^†: VI USA/2016	Descriptive and prospective	To assess the immediate and short-term incidence of complications from catheters in the internal jugular vein.	Ultrasound use.
Zhang et al.³⁴ LoE^†: VI Australia/2016	Descriptive, quantitative	To assess the results of bacteriological culture of intravascular catheters.	PAC^‡‡ colonization.
Marsh et al.³⁵ LoE^†: II Australia/2018a	Randomized clinical trial	To compare two coverage methods for PVC**.	Skin antisepsis.
Rickard et al.³⁶ LoE^†: II Australia/2018	Randomized clinical trial	To compare the effectiveness and costs of three types of PVC** polyurethane dressings.	Skin antisepsis.
Timsit et al.³⁷ LoE^†: V France/2018	Review	To provide updated information on available knowledge on the epidemiology and diagnosis of CVC^§ and PAC^‡‡ complications in the Intensive Care Unit.	Ultrasound use.
Bakan, Arli³⁸ LoE^†: No categorization Turkey/2019	Methodological study, review	To develop a scale to assess nurses’ knowledge and attitudes about healthcare-related infection prevention related to PVC** and CVC^§ use.	Hand hygiene before and after insertion; antiseptic and glove use.
Choudhury et al.³⁹ LoE^†: VI Australia/2019	Descriptive, quantitative	To assess the impact of PVC** insertion site colonization and the occurrence of primary bloodstream infections.	Skin antisepsis.
Lanza et al.⁴⁰ LoE^†: VI Brazil/2019	Descriptive	To analyze nursing professionals’ adherence to preventive measures for PVC** infection.	Skin antisepsis.
Parreira et al. ⁴¹ LoE^†: III Portugal/2019	Clinical trial	To assess the impact of single-use disposable tourniquets and polyurethane dressings with reinforced edges on the occurrence of complications related to PVC** use.	Skin antisepsis.
Simin et al.⁴² LoE^†: IV Serbia/ 2019	Descriptive	To determine the incidence, severity, and risk factors of PVC**-induced complications.	For skin antisepsis, 70% alcohol.
Simonetti et al.⁴³ LoE^†: VI Italy/2019	Descriptive, cross-sectional	To determine nursing students’ theoretical knowledge about evidence-based guidelines for managing PVC** insertion and investigate potential predictive factors associated with adherence to recommendations.	Skin antisepsis.
Buetti et al. ⁴⁴ LoE^†: IV France/2020	Descriptive, quantitative, comparative	To compare the use of two types of chlorhexidine gluconate-impregnated dressings for primary bloodstream infections prevention.	Skin antisepsis, hand antisepsis, sterile glove, sterile field, mask and gown use.
Keogh et al. ⁴⁵ LoE^†: II Australia/2020	Randomized clinical trial	To assess the impact of a multifaceted intervention focused on PVC** maintenance.	Skin antisepsis.
Jiménez-Martínez et al.⁴⁶ LoE^†: VI M exico/2020	Descriptive	To analyze the benefits of cleaning the PVC insertion site as a measure to maintain a functional short PVC as a maintenance option.	Skin antisepsis.
Larsen et al. ⁴⁷ LoE^†: IV Australia/2020	Descriptive, prospective cohort	To identify modifiable and non-modifiable risk factors for PVC** failure.	Skin antisepsis, sterile gloves and sterile, disposable transducer kit.
Liu et al. ⁴⁸ LoE^†: VI China/2020	Descriptive	To identify the incidence, risk factors, and medical costs of complications related to PVC** use.	Skin antisepsis.
Pérez-Granda et al.⁴⁹ LoE^†: II Spain/2020	Randomized clinical trial	To compare the phlebitis and colonization rates of PVC** tip.	Monitor the insertion site, skin antisepsis, 2% alcoholic chlorhexidine, connector disinfection, hand hygiene, change of gauze/dressing.
Schults et al.⁵⁰ LoE^†: VI Australia/2020	Descriptive, quantitative, observational	To describe PAC^‡‡ insertion and management practices and associated complications.	Skin antisepsis and ultrasound use.
Takahashi et al.⁵¹ LoE^†: II Japan/2020	Controlled clinical trial	To establish and assess an intervention method of a package of measures to prevent catheter failures.	Ultrasound use.
Timsit et al.⁵² LoE^†: VII France/2020	Review, guideline	To develop guidelines for CVC^§, PAC^‡‡ and dialysis catheter management in the Intensive Care Unit.	Skin antisepsis.
Vendramim et al.⁵³ LoE^†: II Brazil/2020	Randomized clinical trial	To investigate the non-inferiority of clinically indicated PVC** replacement compared to routine replacement, every 96 hours, to prevent phlebitis.	Skin antisepsis.
Blanco-Mavillard et al.⁵⁴ LoE^†: II Spain/2021	Randomized clinical trial	To determine the effectiveness and costs of a multimodal intervention to reduce PVC** failure.	Skin antisepsis.
Larsen et al.⁵⁵ LoE^†: II Australia/2021	Randomized clinical trial	To compare PAC^‡‡ dressing and fixation methods to prevent device failure in adult Intensive Care Unit.	Skin antisepsis, sterile gloves, lidocaine use.
Rickard et al.⁵⁶ LoE^†: II Australia/2021	Randomized clinical trial	To compare the effectiveness and costs of 7-day versus 4-day infusion set replacement to prevent catheter-related primary bloodstream infections.	Skin antisepsis, sterile field and sterile glove use.

ID* LoE†	Design	Objective	Main results/approach
Covey et al.⁵⁷ LoE^†: VI USA/1988	Descriptive	To examine the effects of three catheter-related healthcare-associated infection prevention protocols.	Change of sterile circuit, saline solution and transducer.
Hospital Infection Control Practices Advisory Committee⁵⁸ LoE^†: V USA/1996	Review	To develop guidelines to reduce infectious complications associated with intravascular device use.	Change of dressing, sterile circuit, saline solution and transducer.
O’Grady et al.¹⁷ LoE^†: VII USA/2002	Review, guideline	To create a guideline for preventing infections related to intravascular catheters.	PAC^‡‡ change time, change of sterile circuit, saline solution and transducer every 96 hours.
Maki et al.⁵⁹ LoE^†: VI USA/2006	Review	To identify the absolute and relative risks of bloodstream infection associated with various types of intravascular devices.	Catheter handling.
Koh et al.²⁰ LoE^†: VI Australia/ 2008	Descriptive, quantitative, observational	To measure colonization and rates of catheter-related bloodstream infection in arterial catheters.	Change of sterile circuit, saline solution and transducer.
Martins et al.²¹ LoE^†: VI Brazil/2008	Descriptive, observational	To check nursing professionals’ adherence to asepsis recommendations when installing and handling the PVC**.	Connection antisepsis.
López et al.²⁴ LoE^†: II Spain/2009	Randomized clinical trial	To investigate the clinical performance of a closed infusion system compared to an open system in PVC**.	Dressing.
Koh et al.²⁶ LoE^†: IV Australia/2012	Descriptive, quantitative, prospective and observational	To determine colonization rates in CVC^§, PAC^I, non-tunneled CVC^§ and PICC^†† segments after removal.	Change of sterile circuit, saline solution and transducer.
López et al. ²⁴ LoE^†: II Spain/2014	Controlled clinical trial	To compare closed system PVC with open system PVC.	Dressing, disinfection of connectors.
Gunther et al.⁶⁰ LoE^†: II France/2016	Randomized clinical trial	To describe post-insertion complications of intravascular access.	Dressing.
Loveday et al.⁶¹ LoE^†: V England/2016	Review	To survey the evidence regarding dressings impregnated with 2% chlorhexidine gluconate.	Dressing.
Marsh et al.³⁵ LoE^†: II Australia/2018a	Randomized clinical trial	To compare two coverage methods for PVC**.	Dressing.
Marsh et al. ⁶² LoE^†: II Australia/2018b	Quantitative, experimental, randomized, controlled	To compare the insertion of a PVC** by a general practitioner and nurse and specialists.	Dressing.
Rickard et al.³⁶ LoE^†: II Australia/2018	Randomized clinical trial	To compare the effectiveness and costs of polyurethane dressings to PVC**.	Dressing and stabilization device.
Timsit et al.³⁷ LoE^†: V France/2018	Review	To provide updated information on the available knowledge on epidemiology and diagnosis of CVC^§ and arterial complications in the Intensive Care Unit.	Catheter change time.
Lanza et al.⁴⁰ LoE^†: VI Brazil/2019	Quantitative, cross-sectional	To analyze nursing professionals’ adherence to preventive measures for PVC** infection.	Connection antisepsis.
Etafa et al.⁶³ LoE^†: VI Ethiopia /2020	Descriptive	To assess undergraduate nursing students’ knowledge about evidence-based guidelines on PVC** management.	Hand hygiene, polyurethane dressing and gauze.
Liu et al.⁴⁸ LoE^†: VI China/2020	Descriptive	To identify the incidence, risk factors, and medical costs of PVC-induced complications.	Sterile transparent film use.
Schults et al.⁵⁰ LoE^†: VI Australia/2020	Descriptive, quantitative, observational	To describe PAC^‡‡ insertion and management practices and associated complications.	Coverage and stabilization for PAC^‡‡.
Larsen et al.⁵⁵ LoE^†: II Australia/2021	Randomized clinical trial	To establish the feasibility of a randomized controlled trial comparing methods of dressing and securing arterial catheters to prevent device failure.	Complications when using PAC^‡‡ with dressing.
Rickard et al.⁵⁶ LoE^†: II Australia/2021	Randomized clinical trial	To compare the effectiveness and costs of 7-day versus 4-day infusion set replacement to prevent bloodstream infection related to CVC^§, tunneled CVC^§, PICC^††, and PAC^‡‡.	Change of sterile circuit, saline solution and transducer, antisepsis of dressings connectors.
Silva et al. ⁶⁴ LoE^†: VI Brazil/2021	Descriptive	To identify PVC^II bloodstream infection control.	Dressing.

ID* LoE†	Design	Objective	Main results/approach
Hospital Infection Control Practices Advisory Committee⁵⁸LoE^†: V USA/1996	Review	To develop guidelines to reduce infectious complications associated with intravascular device use.	Cateter use time.
Timsit et al.³⁷ LoE^†: V France/2018	Review	To provide up-to-date information on the epidemiology and diagnosis of central venous catheter and peripheral arterial catheter complications.	Catheter use time and complications, ultrasound use, antisepsis.
Lye et al. ⁶⁵ LoE^†: V Australia/2019	Review	To assess the current literature related to removal versus retention of central venous catheters and intra-arterial lines with suspected infection in the adult intensive care population.	Cateter use time.

[TFN1] *ID: article identification; ^†LoE: level of evidence; **PVC: peripheral venous catheter; ^§CVC: central venous catheter; ^‡‡ PAC: peripheral arterial catheter.