The effect of three-way stopcock on CLABSI risk
Abstract:
Objective: Central line-associated bloodstream infection (CLABSI) is a major cause of morbidity in pediatric cardiac intensive care units. Closed vascular access systems are modern devices used to prevent both needle-stick injuries and CLABSI. This study aimed to compare CLABSI rates between three-way stopcock (TWS) systems and closed vascular access systems (CVAS) in a pediatric cardiovascular surgery intensive care unit (PCSICU).
Methods: This study included patients with central venous catheters (CVC) between September 1, 2024, and October 31, 2025. CVC bundle practices were used in this study. The study included 2 time periods: the 7-month TWS period before the initiation of the CVAS, and the 7-month CVAS period.
Results: A total of 111 patients were included. In the 7-month TWS period, 48 patients were admitted to the PCSICU, 334 patient days, and 312 CVC days were recorded. During the CVAS period, 63 patients were admitted to the PCSICU, and 277 patient days and 274 CVC days were recorded. The CLABSI rate decreased from 12.8 per 1000 catheter-days in the TWS period to 0 per 1000 catheter-days in the CVAS period [Poisson comparison, p = 0.17]
Conclusions: The CLABSI was not observed in the CVAS period. These findings suggest that closed systems, which may reduce line manipulation, could contribute to lowering CLABSI risk, warranting further investigation in larger studies.
Reference:
Çine N, Dinç C, Akkaya G, Oruç Y, Aktürk E, Çiçek AN, Özalp Gerçeker G, Devrim İ. The effect of three-way stopcock and closed vascular access systems on central line-associated bloodstream infection in the pediatric cardiac surgery intensive care unit. J Vasc Access. 2026 Aug 6:11297298261471695. doi: 10.1177/11297298261471695. Epub ahead of print. PMID: 42563290.