How often are infusion sets for central venous catheters changed in Australian and New Zealand Intensive Care Units? A point prevalence survey

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.

Keywords: Central venous catheters; Infusion sets; Intensive care; Sustainability.