Rates of infection for single-lumen versus multilumen central venous catheters: A meta-analysis
- 1 September 2003
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in Critical Care Medicine
- Vol. 31 (9), 2385-2390
- https://doi.org/10.1097/01.ccm.0000084843.31852.01
Abstract
Since the introduction of multilumen central venous catheters two decades ago, there has been controversy whether the additional lumens place patients with these catheters at higher risk for infection. Our objective was to determine the risk of catheter-related bloodstream infection (CRBSI) and catheter colonization in multilumen catheters compared with single-lumen catheters. Studies were identified by a computerized search of MEDLINE, EMBASE, CINAHL, Current Contents, and PREMEDLINE databases and by review of bibliographies and expert consultation. Studies comparing the prevalence of CRBSI or catheter colonization among single-, double-, and triple-lumen central venous catheters were included. We excluded studies if they included central venous catheters that were long-term, cuffed, tunneled, or coated with antibiotic or antiseptic agents. Two independent reviewers abstracted data on: 1) risk factors for CRBSI and colonization, 2) outcome definitions used, 3) the absolute prevalence of CRBSI and catheter colonization, and 4) study design and quality. A total of 15 studies met inclusion criteria. Summary odds ratios were calculated using a random-effects model. Although CRBSI was more common in multilumen catheters (summary odds ratios, 2.15; 95% confidence interval, 1.00-4.66), catheter colonization was not (summary odds ratios, 1.78; 95% confidence interval, 0.92-3.47). Tests for heterogeneity, however, suggested substantial variation by study. When only studies of higher quality were included, multilumen catheters were found not to be associated with a significant increase in CRBSI prevalence (summary odds ratios, 1.30; 95% confidence interval, 0.50-3.41). Multilumen central venous catheters may be associated with a slightly higher risk of infection when compared with single-lumen catheters; however, this relationship diminishes when only high-quality studies that control for patient differences are considered. The slight increase in infectious risk when using multilumen catheters is likely offset by their improved convenience, thereby justifying the continued use of multilumen vascular catheters.Keywords
This publication has 28 references indexed in Scilit:
- The Clinical and Economic Consequences of Nosocomial Central Venous Catheter-Related Infection: Are Antimicrobial Catheters Useful?Infection Control & Hospital Epidemiology, 2000
- Prevention of Intravascular Catheter–Related InfectionsAnnals of Internal Medicine, 2000
- Cost-Effectiveness of Antiseptic-Impregnated Central Venous Catheters for the Prevention of Catheter-Related Bloodstream InfectionJAMA, 1999
- Risk of Infection Due to Central Venous Catheters: Effect of Site of Placement and Catheter TypeInfection Control & Hospital Epidemiology, 1998
- Total Parenteral Nutrition via Multilumen Catheters Does Not Increase the Risk of Catheter-Related Sepsis: A Randomized, Prospective StudyClinical Infectious Diseases, 1998
- Single- versus triple-lumen central catheter-related sepsis: A prospective randomized study in a critically ill populationAmerican Journal Of Medicine, 1992
- Infection Rate for Single Lumen v Triple Lumen Subclavian CathetersInfection Control & Hospital Epidemiology, 1988
- Risk of Infection Accompanying the Use of Single‐Lumen vs Double‐Lumen Subclavian Catheters: A Prospective Randomized StudyJournal of Parenteral and Enteral Nutrition, 1988
- Clinical Experience with the Multiple Lumen Central Venous CatheterJournal of Parenteral and Enteral Nutrition, 1986
- Comparison of the sterility of long-term central venous catheterization using single lumen, triple lumen, and pulmonary artery cathetersCritical Care Medicine, 1984