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2011 Guidelines for the Prevention of Intravascular Catheter-Related Infections

Download the complete 2011 Guidelines for the Prevention of Intravascular Catheter-Related Infections [PDF - 1.05 MB]

Table 1. Catheters used for venous and arterial access.
Catheter type Entry Site Length Comments
Peripheral venous catheters Usually inserted in veins of forearm or hand <3 inches Phlebitis with prolonged use; rarely associated with bloodstream infection
Peripheral arterial catheters Usually inserted in radial artery; can be placed in femoral, axillary, brachial, posterior tibial arteries <3 inches Low infection risk; rarely associated with bloodstream infection
Midline catheters Inserted via the antecubital fossa into the proximal basilic or cephalic veins; does not enter central veins, peripheral catheters 3 to 8 inches Anaphylactoid reactions have been reported with catheters made of elastomeric hydrogel; lower rates of phlebitis than short peripheral catheters
Nontunneled central venous catheters Percutaneously inserted into central veins (subclavian, internal jugular, or femoral) ≥8 cm depending on patient size Account for majority of CRBSI
Pulmonary artery catheters Inserted through a TeflonĀ® introducer in a central vein (subclavian, internal jugular, or femoral) ≥30 cm depending on patient size Usually heparin bonded; similar rates of bloodstream infection as CVCs; subclavian site preferred to reduce infection risk
Peripherally inserted central venous catheters (PICC) Inserted into basilic, cephalic, or brachial veins and enter the superior vena cava ≥20 cm depending on patient size Lower rate of infection than nontunneled CVCs
Tunneled central venous catheters Implanted into subclavian, internal jugular, or femoral veins ≥8 cm depending on patient size Cuff inhibits migration of organisms into catheter tract; lower rate of infection than nontunneled CVC
Totally implantable Tunneled beneath skin and have subcutaneous port accessed with a needle; implanted in subclavian or internal jugular vein ≥8 cm depending on patient size Lowest risk for CRBSI; improved patient self-image; no need for local catheter-site care; surgery required for catheter removal
Umbilical catheters Inserted into either umbilical vein or umbilical artery ≥6 cm depending on patient size Risk for CRBSI similar with catheters placed in umbilical vein versus artery

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