From the Guidelines
The most common cause of death related to a central venous catheter is catheter-related sepsis (option e). Catheter-related sepsis occurs when bacteria colonize the catheter and enter the bloodstream, leading to a systemic infection that can progress to septic shock and death if not promptly treated. This complication develops in approximately 5-8% of central venous catheters, with mortality rates ranging from 12-25% in severe cases, as reported in a study by 1. The risk increases with longer catheter dwell times, improper insertion technique, inadequate site care, and in immunocompromised patients. Prevention strategies include strict aseptic technique during insertion, chlorhexidine skin preparation, appropriate dressing changes, and prompt removal of unnecessary catheters.
Some key points to consider in the management of central venous catheters include:
- The use of ultrasound guidance during insertion to reduce the risk of complications, as recommended by 1
- The importance of proper catheter care and maintenance to prevent infection, as emphasized by 1
- The need for prompt removal of the catheter in cases of suspected infection or sepsis, as advised by 1
- The use of antibiotic lock therapy as an adjunct to systemic antibiotic treatment in cases of catheter-related bloodstream infection, as discussed by 1
While air embolism, central vein perforation, tension pneumothorax, and catheter embolism are all serious complications of central venous catheterization, they occur less frequently than catheter-related sepsis and are generally associated with lower mortality rates when promptly recognized and treated, as noted in a study by 1. Therefore, it is essential to prioritize the prevention and management of catheter-related sepsis to minimize the risk of morbidity and mortality associated with central venous catheters.
From the Research
Causes of Death Related to Central Venous Catheters
- The most common cause of death related to a central venous catheter is catheter-related sepsis 2, 3, 4, 5.
- Catheter-related sepsis occurs when bacteria enter the bloodstream through the catheter, leading to infection and potentially life-threatening complications.
- Studies have shown that catheter-related sepsis is a significant cause of morbidity and mortality in patients with central venous catheters 2, 3, 4, 5.
- Other options, such as air embolism, central vein perforation, tension pneumothorax, and catheter embolism, are potential complications of central venous catheters, but they are not the most common cause of death related to these devices.
- The prevention of catheter-related sepsis is crucial to reducing the risk of death and other complications associated with central venous catheters 4, 5.