Early prophylaxis of central venous catheter-related thrombosis using 1% chlorhexidine gluconate and chlorhexidine-gel-impregnated dressings: a retrospective cohort study.

Tomoko Yamashita, Ayako Takamori, Akira Nakagawachi, Yoshinori Tanigawa, Yohei Hamada, Yosuke Aoki, Yoshiro Sakaguchi

Journal: Scientific reports 2021;10(1):15952

PMID: 32994455

Free Full Text on Nature Publishing Group View on PubMed

Abstract

To determine the prophylactic effect of using combined 1% alcoholic chlorhexidine gluconate and chlorhexidine gel-impregnated dressings (CGCD) on catheter-related thrombosis (CRT) in critically ill patients. This retrospective cohort study was performed in an intensive care unit from November 2009 to August 2014. The CRT incidence diagnosed with ultrasound examination was compared between patients applying CGCD and combined 10% aqueous povidone-iodine and standard transparent dressings (PITD) after central venous catheter insertion into the internal jugular vein for ≥ 48 h. CRT was stratified into early (within 7 days) and late (days 8-14) thromboses. Multivariate analyses using logistic regression models clarified the relationships between early- and late-CRT risks and skin antiseptic and catheter site dressing combinations. CRT occurred in 74 of 134 patients (55%), including 52 with early CRT and 22 with late CRT. Patients receiving CGCD had a significantly lower incidence of early CRT than those receiving PITD (odds ratio = 0.18; 95% confidence interval = 0.07-0.45, p < .001). No significant association was evident between using CGCD and late CRT (p = .514). Compared to PITD, CGCD reduced the CRT risk over 7 days in critically ill patients.UMIN Clinical Trials Registry: UMIN000037492.

Address: Intensive Care Unit, Saga University Hospital, 5-1-1, Nabeshima, Saga City, Saga, 849-8501, Japan. [email protected].; Clinical Research Center, Saga University Hospital, 5-1-1, Nabeshima, Saga City, Saga, 849-8501, Japan.; Intensive Care Unit, Saga University Hospital, 5-1-1, Nabeshima, Saga City, Saga, 849-8501, Japan.; Division of Infectious Disease and Hospital Epidemiology, Saga University Hospital, 5-1-1, Nabeshima, Saga City, Saga, 849-8501, Japan.; Department of Anesthesiology and Critical Care Medicine, Faculty of Medicine, Saga University, 5-1-1, Nabeshima, Saga City, Saga, 849-8501, Japan.

DOI: 10.1038/s41598-020-72709-w

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https://antibodies.cancer.gov/detail/CPTC-CALR-1

MeSH Terms: Adult, Aged, Aged, 80 and over, Anti-Infective Agents, Local, Bandages, Catheter-Related Infections, Catheterization, Central Venous, Central Venous Catheters, Chlorhexidine, Cohort Studies, Critical Illness, Equipment Contamination, Female, Gels, Humans, Intensive Care Units, Japan, Male, Middle Aged, Odds Ratio, Povidone-Iodine, Prophylactic Surgical Procedures, Retrospective Studies, Risk Factors, Venous Thrombosis