Central venous catheters—time for a change?BMJ 1998; 316 doi: https://doi.org/10.1136/bmj.316.7149.1918 (Published 27 June 1998) Cite this as: BMJ 1998;316:1918
- Michael O'Leary, Senior registrar,
- David Bihari, Associate professor
- Intensive Care Unit, St George Hospital, Kogarah, NSW 2217, Australia
If you put them in properly you don't need to change them routinely
It is often difficult to ascertain exactly where a particular medical practice or policy originates. Thus it is with routine scheduled changes of central venous catheters in patients requiring prolonged intensive care. If we are to believe the telephone survey by Cyna et al in this week's issue (p 1944),1 the policy of routinely replacing central venous catheters to reduce a perceived high incidence of catheter related sepsis appears to be ingrained in many British intensive care units. That this policy continues is surprising, since it is impossible to find a published randomised trial in the past 12 years supporting the contention that the incidence of catheter related sepsis increases with duration of catheterisation.
Indeed, there are now several randomised controlled trials comparing routine catheter change with change when clinically indicated, and these have …