Central line-associated bloodstream infections in patients with COVID-19.
Nicole Caetano Acosta, Rodrigo do Nascimento Ceratti, Marina Scherer Santos and 4 others
PMID 39082503WHAT IT FOUND
Longer invasive ventilation and proning were associated with central line infections in ICU patients with COVID-19.
Infection appeared after an average 11 days. Review line care during prolonged ventilation and proning.
Key findings
01Patients with CLABSI spent 20 (13.7 to 27.2) days on invasive mechanical ventilation compared with 15 (12 to 23) days in controls (P=0.014).
02Pronation was associated with CLABSI: 67.1% of cases versus 45.7% of controls (P=0.017; odds ratio 2.41, 95% confidence interval 1.22 to 4.81).
03The average time to CLABSI was 11 (8 to 18) days.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Data were collected retrospectively from medical records, so recording may have been incomplete or unsatisfactory. The study was done in one ICU, so the findings may not transfer to other settings. This was an observational case-control study, so it can only show associations, not cause and effect. Patients had many invasive devices and treatments, and the study could not separate the effect of each care process. The authors noted that COVID-19 was an emerging disease and vascular access data may still be insufficient for some associations.
The easy way to misread this
Do not conclude that proning or longer ventilation causes central line infection. This retrospective case-control study only found associations, and patients who were more severely ill may have had more line manipulation and harder line-site care.