Chlorhexidine-impregnated dressing for the prophylaxis of central venous catheter-related complications: a systematic review and meta-analysis

Abstract

Background Several randomized controlled trials (RCTs) evaluated the role of Chlorhexidine-impregnated dressing for prophylaxis of central venous catheter (CVC) related complications, but the results remained inconsistent, updated meta-analyses on this issue are warranted. Methods A meta-analysis on the RCTs comparing Chlorhexidine-impregnated dressing versus other dressing or no dressing for prophylaxis of central venous catheter-related complications was performed. A comprehensive search of major databases was undertaken up to 30 Dec 2018 to identify related studies. Pooled odd ratio (OR) and mean differences (MDs) with 95% confidence intervals (CI) were calculated using either a fixed-effects or random-effects model. Subgroup analysis was performed to identify the source of heterogeneity, and funnel plot and Egger test was used to identify the publication bias. Results A total of 12 RCTs with 6028 patients were included. The Chlorhexidine-impregnated dressings provided significant benefits in reducing the risk of catheter colonization (OR = 0.46, 95% CI: 0.36 to 0.58), decreasing the incidence of catheter-related bloodstream infection (CRBSI) (OR = 0.60, 95% CI: 0.42 to 0.85). Subgroup analysis indicated that the Chlorhexidine-impregnated dressings were conducive to reduce the risk of catheter colonization and CRBSI within the included RCTs with sample size more than 200, but the differences weren’t observed for those with sample less than 200. No publication bias was observed in the Egger test for the risk of CRBSI. Conclusions Chlorhexidine-impregnated dressing is beneficial to prevent CVC-related complications. Future studies are warranted to assess the role and cost-effectiveness of Chlorhexidine-impregnated dressings.

Central venous catheter–related infections in hematology and oncology: 2020 updated guidelines on diagnosis, management, and prevention by the Infectious Diseases Working Party (AGIHO) of the German Society of Hematology and Medical Oncology (DGHO)

“…CHX-impregnated dressings were tested in cancer and ICU patients in randomized trials showing a reduction in CRI rates compared with standard dressings, and this finding could be confirmed in a recent systematic review and meta-analysis [31, [144][145][146][147][148]. A recent multicenter randomized trial studied the use of dressings containing CHX-containing gel pads compared with standard non-impregnated dressings in 613 neutropenic cancer patients using the stringent definition of definite CRBSI and probable CRBSI [10,31].…”

Chlorhexidine-impregnated sponge versus chlorhexidine gel dressing for short-term intravascular catheters: which one is better?

“…A recent meta-analysis showed that chlorhexidine-impregnated dressings reduced catheter-related bloodstream infections [ 9 ]. To our knowledge, a direct comparison between gel-dress and sponge-dress has never been performed.…”

“…Several prevention measures are well known in the literature [3][4][5][6][7]. Among them, chlorhexidine-impregnated dressings were beneficial in various studies to prevent catheter-related bloodstream infections [8,9] and were currently recommended by the Centers for Disease Control and Prevention (CDC) [10]. Two types of chlorhexidine-impregnated dressing are currently used: chlorhexidine-impregnated sponges (spongedress) [11] and chlorhexidine gel dressing (gel-dress) [12].…”

Perfil microbiológico da colonização do sítio de inserção do cateter venoso central considerando dois curativos transparentes

“…A maioria dos achados da literatura em relação ao CGCHX tratam da sua capacidade de redução de infecção de corrente sanguínea relacionada ao cateter ou redução de colonização do CVC 4,9,10,[13][14][15][16][17][18][19][20] .…”

“…Dois estudos recentes 13,16,20 demonstraram que os curativos impregnados com clorexidina reduzem as taxas de infecção relacionada ao cateter ou o risco de colonização de cateter venoso central, porém com algumas ressalvas.…”