Contamination of Guidewires During Insertion of Central Venous Catheters in an Intensive Care Setting

Preventing contamination at the time of central venous catheter insertion: a literature review and recommendations for clinical practice

“…There are other potential sources of catheter contamination at the time of insertion. Palmer and Solano () found 8·2% of 158 guidewires sampled following CVC insertion were positive for micro‐organisms. These cultures were subsequently predictive of catheter tip colonisation.…”

“…Optimising skin antisepsis at the time of catheter insertion is considered important in improving health outcomes (Elliot et al . , Palmer & Solano ). In recent years, there has been an increased emphasis on full barrier precautions when inserting CVCs (Pronovost et al .…”

“…Standards for inserting central venous catheters (CVCs) are constantly evolving as new strategies and evidence about risk reduction emerge (Alexandrou et al 2010a,b, O'Grady et al 2011. Optimising skin antisepsis at the time of catheter insertion is considered important in improving health outcomes (Elliot et al 1997, Palmer & Solano 2005. In recent years, there has been an increased emphasis on full barrier precautions when inserting CVCs (Pronovost et al 2006).…”

Guidewire exchange vs new site placement for temporary dialysis catheter insertion in ICU patients: is there a greater risk of colonization or dysfunction?

“…In a pilot study Palmer et al demonstrated that guidewire contamination during central line placement predisposes to subsequent colonization of the inserted catheter [ 19 ]. This is why replacement by GWE of a non-tunnelled catheter that is suspected to be infected is discouraged, but it may be used to replace a malfunctioning catheter when there is no evidence of catheter infection [ 14 ].…”

Case report: Managing a knotted Seldinger wire in the subclavian vein during central venous cannulation

“…14 In one case, excessive introduction of a guidewire caused a cyst arising from the tricuspid valve annulus to prolapse into the right ventricular outflow tract and cause cardiac arrest with electromechanical dissociation. 15 Contamination 16 of the guidewire during insertion has been reported in the literature as well as misplacement and loss of guidewires in the cardiovascular system. 17 Special precautions are required in patients with inferior vena cava filters since there have been numerous reports of entrapment of guidewire in these filters.…”