Abstract
Central venous catheters (CVCs) are frequently used, but the rate of complications is high. This study evaluates the effects of a short training program for CVC insertion in a university-based teaching hospital. A sample of adults with CVCs inserted outside the intensive care unit was selected from two academic years: 2015, year without structured training, and 2016, year with structured training. Clinical and laboratory information, as well as the procedure’s characteristics and complications (mechanical and infectious) were collected. The incidence of complications before and after the training was compared. A total of 1502 punctures were evaluated. Comparing the pre- and post-training period, there was an increase in the choice for jugular veins and the use of ultrasound. A numerical reduction in the rate of complications was identified (RR 0.732; 95% CI 0.48–1.12; P = 0.166). This difference was driven by a statistically significant lower rate of catheter-related infections (RR 0.78; 95% CI 0.64–0.95; P = 0.047). In the multivariate analysis, aspects regarding technique (ultrasound use, multiple punctures) and year of training were associated with outcomes. Structured training reduces the rate of complications related to CVC insertion, especially regarding infections.
Highlights
Central venous catheters (CVCs) are frequently used, but the rate of complications is high
The use of the subclavian vein is more related to pneumothorax and less related to infections, and the internal jugular vein and femoral vein are more related to arterial perforation[3,5]
Exclusion criteria were radiography that did not follow a new procedure, radiography performed on inpatients admitted to the intensive care unit (ICU), peripherally inserted CVCs, and CVCs placed via the femoral vein
Summary
Central venous catheters (CVCs) are frequently used, but the rate of complications is high. This study evaluates the effects of a short training program for CVC insertion in a university-based teaching hospital. Structured training reduces the rate of complications related to CVC insertion, especially regarding infections. The rate of complications associated with the insertion procedure is high It is a significant cause of preventable morbidity and mortality[2]. To prevent mechanical complications, an increasing number of insertions have been conducted under ultrasonography, leading to a lower rate of c omplications[8]. This resource is still not widely available in Brazil or other low- or middle-income countries. The objective of this study was to compare the rate of complications before (the academic year of 2015) and after (the academic year of 2016) this education program
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