Author:
van der Mee-Marquet Nathalie,Valentin Anne-Sophie,Duflot Isabelle,Farizon Mathilde,Petiteau Agnès,Allaire Alexandra,Sovic Elise Balestrat,Barbut Frédéric,Barthelemy Patrick,Berger Pierre,Betti Marie-Camille,Blanié Mathilde,Cattaneo Isabelle,Cecille Agnès,Chakaroun Hiba,Cholley Anne-Clémence,David Marion,Davy Aude,Delhomme Joël,Duval Catherine,Edouard Stéphanie,Gabriele Laure,Gallais Séverine,Gerbier Colette,Manquat Gilles,Goldstein Valérie,Gourdon Florence,Joron Sylvie,Kayoulou-Bour Anne-Marie,Laethem Gratienne,Lemann Florence,Lemenager Martine,Lier Marie-Laure,Mesnil Malcie,Mertel Nadine,Morange Virginie,Mottet Benoit,Niot Stella,Ouzani Souad,Perdrix Christophe,Renaud Amélie,Richaud Clémence,Rougier Catherine,Tarsac Maryline,Venelle Myriam,Vidal Isabelle,
Abstract
Abstract
Background
Central catheters expose ICU patients at risk of catheter-related bloodstream infections. A mechanism by which these infections occur is the contamination of the catheter during its insertion if aseptic techniques are not strictly applied. Recent studies suggest that the use of ultrasound guidance (USG) may increase the risk of catheter contamination during insertion. We assessed current practices regarding the use of USG during catheter insertion, with a focus on identifying breaches of the surgical asepsis required for this invasive procedure.
Methods
In 26 intensive care units, we evaluated the use of USG during catheter insertion, using a questionnaire addressed to intensivists and direct observation of their practices.
Results
We analyzed 111 questionnaires and 36 observations of intensivists placing catheters. The questionnaires revealed that 88% of intensivists used USG for catheter insertion. Among those using USG, 56% had received specific training, 17% benefited from specific recommendations, 76% marked the insertion site before skin antisepsis, and during catheter insertion, 96% used sterile gel and 100% used a sterile sheath and sterile gloves. We identified potential deviations from strict aseptic technique, including contact between the sheath and the needle (19.4%), handling of the US system during catheter insertion (2.8%), and use of sterile devices, where they were not yet necessary (during the marking site or skin antisepsis), resulting in their contamination at the time of catheter insertion.
Conclusions
Interventions aimed at ensuring compliance with measures to prevent CRBs should be organized to prevent an increase in infections associated with US-guided catheter insertion.
Publisher
Springer Science and Business Media LLC
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