Reassessing the need for scheduled replacement of short term central venous catheters: A narrative comprehensive review

Abstract

SUMMARY: Central venous catheters (CVCs) are essential in modern healthcare but are associated with significant risks, particularly catheter-related bloodstream infections (CRBSIs). Current guidelines do not recommend routine replacement of CVCs based on time alone. However, recent evidence challenges this recommendation. A comprehensive literature review was conducted, focusing on studies exploring the risk-factors of short-term, non-hemodialysis CVCs, that were published in the last two decades while including seminal older works for context. The guidelines regarding scheduled CVC-replacement are not based on sufficiently convincing data. Current literature establishes the significance of CVC-duration as a major risk-factor for CRBSI occurrence, especially after 9–14 days of catheter-dwelling. The daily CRBSI risk is probably not constant, and the cumulative risk may reach high rates after 9–14 days, especially for femoral and jugular insertions compared to the subclavian site, suggesting potential benefits of scheduled CVC replacement, especially for non-subclavian catheters.

Keywords

• Central venous catheter
• Catheter-related bloodstream infection
• Dwell time
• Scheduled replacement
• Infection control