Is routine changing of peripheral arterial catheters justified?

Abstract

Although peripheral arterial catheters (pACs) are used extensively, disagreement persists concerning the practice of scheduled replacement to prevent catheter-related infections. Despite recommendations and no proof of benefit, pAC replacement continues to be scheduled as a routine practice in many intensive care units (ICUs) worldwide. Our own experience in an oncology ICU, based on a 217-device database, confirms that the risk for pAC-related infections is stable over time, arguing against scheduled replacement. The low rate and stability of the risk of pAC-related infections supports the rationale for conservative management in accordance with expert recommendations.

Arterial catheter-related bloodstream infections: Results of an 8-year survey in a surgical intensive care unit*

“…More recently, Khalifa et al (9) reported an increased risk of colonization in ACs that were in place for Ͼ10 -14 days, whereas Lucet et al (10) published similar results for ACs that remained in place for Ͼ8 days. However, these reports are not consistent with those by Blot et al (11) and Koh et al (5); those studies suggest that the instantaneous risk of catheter infections is stable over time.…”

“…Different hypotheses may be proposed to explain such results. First, the risk of colonization might be constant over time (5,11). Second, other factors might contribute to the increased ACBI risk in cases of systematic replacement.…”