Infusion set change frequency
Abstract:
Background: Infusion sets (comprising the tubing, measuring burettes, fluid containers, transducers) that are connected to invasive vascular devices are changed on a regular basis in an effort to reduce bacterial colonisation and bloodstream infection. There is a balance between reducing infection and creating unnecessary waste. Current evidence suggests that for central venous catheters (CVCs), changing infusion sets at 7 days does not increase infection risks.
Objectives: The objective of this study was to describe the current unit guidelines in Australian and New Zealand intensive care units (ICUs) for changing infusion sets for CVCs.
Methods: prospective cross-sectional point prevalence study, as a part of the 2021 Australian and New Zealand Intensive Care Society Point Prevalence Program.
Participants: Australia and New Zealand (ANZ) adult ICUs and their patients on the day of the study.
Results: Data were collected from 51 ICUs across ANZ. One-third of these (16/49) ICUs had a guideline that specified a 7-day replacement period, with the rest having a more frequent replacement period.
Conclusion: Most ICUs participating in this survey had policies to change their CVC infusion tubing in 3-4 days, and recent high-level evidence supports an update to extend this to 7 days. There remains work to be done to spread this evidence to ANZ ICUs and improve environmental sustainability initiatives.
Reference:
Anstey MH, Maxwell N, Rickard CM, Hammond NE, Knowles S, McGain F; George Institute for Global Health and the Australian and New Zealand Intensive Care Society Clinical Trials Group, Steering Committee members; Coordinating centre List of investigators; Site List of investigators. How often are infusion sets for central venous catheters changed in Australian and New Zealand Intensive Care Units? A point prevalence survey. Aust Crit Care. 2023 Jun 27:S1036-7314(23)00068-1. doi: 10.1016/j.aucc.2023.05.004. Epub ahead of print. PMID: 37385895.