Chlorhexidine gluconate transparent dressing does not decrease central line-associated bloodstream infection in critically ill patients: A randomized controlled trial.
Kunrong Yu, Meishan Lu, Yanling Meng and 2 others
PMID 31631496WHAT IT FOUND
Chlorhexidine dressing did not lower central line bloodstream infection rates versus standard dressing in ICU patients.
It required fewer dressing changes, but dressing cost was higher.
Key findings
01Chlorhexidine dressing did not significantly lower CLABSI rates compared with standard dressing (5.68 and 4.93 per 1000 catheter days; P = .256 and P = .868).
02Chlorhexidine dressing required fewer dressing changes per central line than standard dressing (average frequency 2 versus 3; P < .001).
03Chlorhexidine dressing cost more than standard dressing (average $31.8 versus $5.6; P < .001), and CLABSI antibiotic costs were not significantly lower (average $387 versus $540; P = .141).
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How it was doneWhat they foundWhat it means for RNs
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What it does not show
It was done in one medical ICU in Beijing, so the results may not apply to other hospitals. The dressing type was visible, so nurses and clinicians were not blinded. 45 of 304 patients had more than one central line in sequence, and lines from the same patient could be assigned to different groups. The paper reports inconsistent line counts: 474 central lines were analyzed, but the results also give 259 chlorhexidine lines and 219 control lines. Only 14 infections occurred, and the paper did not determine whether infections came from the insertion site or the catheter lumen. Costs used local Chinese prices, so cost comparisons may not transfer to other settings.
Declared interests
The authors declared no conflict of interest.
The easy way to misread this
Do not conclude that chlorhexidine dressing prevents CLABSI. The primary infection rate was not lower than standard dressing, and the dressing cost was higher.