Abstract

The effect on the rate of central venous catheter sepsis of incorporating the catheter hub in a povidone-iodine (Betadine) connection shield was evaluated in a randomized controlled clinical trial involving 47 Silastic catheters inserted in 35 patients solely for the administration of parenteral nutrition. All catheters were tunneled subcutaneously and once inserted were randomized to one of two subsequent management groups. Group 1 (n = 25) were managed in a standard fashion whereas Group 2 catheters (n = 22) in addition were managed by incorporating the catheter hub in a Betadine connection shield (Connection Shield 3; Travenol/Baxter). The catheter lifespans in the two groups were similar (Group 1 mean 10.8 days; range 3-28: Group 2 mean 13.3 days: range 5-31). There was a significant difference in the rates of both clinical sepsis (Group 1, 8 cases; 32%; Group 2, 1 case; 4.5%; p less than 0.05) and bacteriologic sepsis (Group 1, 6 cases; 24%; Group 2, 0 cases; p less than 0.05) in the two groups. Incorporating the catheter hub in a Betadine connection shield confers significant benefit in terms of reducing the incidence of catheter sepsis in patients receiving total parenteral nutrition.