Skip to main content Accessibility help

Prevalence of the Use of Central Venous Access Devices Within and Outside of the Intensive Care Unit: Results of a Survey Among Hospitals in the Prevention Epicenter Program of the Centers for Disease Control and Prevention

  • Michael Climo (a1), Dan Diekema (a2), David K. Warren (a3), Loreen A. Herwaldt (a2), Trish M. Perl (a4), Lance Peterson (a5), Theresa Plaskett (a6), Connie Price (a7), Kent Sepkowitz (a6), Steve Solomon (a8), Jerry Tokars (a8), Victoria J. Fraser (a3) and Edward Wong (a1)...



To determine the prevalence of central venous catheter (CVC) use among patients both within and outside the ICU setting.


A 1-day prevalence survey of CVC use among adult inpatients at six medical centers participating in the Prevention Epicenter Program of the CDC. Using a standardized form, observers at each Epicenter performed a hospital-wide survey, collecting data on CVC use.


Inpatient wards and ICUs of six large urban teaching hospitals.


At the six medical centers, 2,459 patients were surveyed; 29% had CVCs. Among the hospitals, from 43% to 80% (mean, 59.3%) of ICU patients and from 7% to 39% (mean, 23.7%) of non-ICU patients had CVCs. Despite the lower rate of CVC use on non-ICU wards, the actual number of CVCs outside the ICUs exceeded that of the ICUs. Most catheters were inserted in the subclavian (55%) or jugular (22%) site, with femoral (6%) and peripheral (15%) sites less commonly used. The jugular (33.0% vs 16.6%; P < .001) and femoral (13.8% vs 2.7%; P < .001) sites were more frequently used in ICU patients, whereas peripherally inserted (19.9% vs 5.9%; P < .001) and subclavian (60.7% vs 47.3%; P < .001) catheters were more commonly used in non-ICU patients.


Current surveillance and infection control efforts to reduce morbidity and mortality associated with bloodstream infections concentrate on the high-risk ICU patients with CVCs. Our survey demonstrated that two-thirds of identified CVCs were not in ICU patients and suggests that more efforts should be directed to patients with CVCs who are outside the ICU.


Corresponding author

Hunter Holmes McGuire Veteran Affairs Medical Center, 1201 Broad Rock Blvd., Section 111-C, Richmond, VA 23249


Hide All
1.National Nosocomial Infections Surveillance (NNIS) System report: data summary from January 1992 to June 2002, issued August 2002. Am J Infect Control 2002;30:458475.
2.Gikas, A, Pediaditis, J, Papadakis, JA, et al. Prevalence study of hospital-acquired infections in 14 Greek hospitals: planning from the local to the national surveillance level. J Hosp Infect 2002;50:269275.
3.Richards, MJ, Edwards, JR, Culver, DH, Gaynes, RP. Nosocomial infections in medical intensive care units in the United States. Crit Care Med 1999;27:887892.
4.Gastmeier, P, Weist, K, Ruden, H. Catheter-associated primary bloodstream infections: epidemiology and preventive methods. Infection 1999;27(suppl 1):S1S6.
5.Ronveaux, O, Jans, B, Suetens, C, Carsauw, H. Epidemiology of nosocomial bloodstream infections in Belgium, 1992-1996. Eur J Clin Microbiol Infect Dis 1998;17:695700.
6.Safdar, N, Kluger, DM, Maki, DG. A review of risk factors for catheter-related bloodstream infection caused by percutaneously inserted, non-cuffed central venous catheters: implications for preventive strategies. Medicine (Baltimore) 2002;81:466479.
7.Merrer, J, De Jonghe, B, Golliot, F, et al. Complications of femoral and subclavian venous catheterization in critically ill patients: a randomized controlled trial. JAMA 2001;286:700707.
8.Chaiyakunapruk, N, Veenstra, DL, Lipsky, BA, Saint, S. Chlorhexidine compared with povidone-iodine solution for vascular catheter-site care: a meta-analysis. Ann Intern Med 2002;136:792801.
9.Raad, II, Hohn, DC, Gilbreath, BJ, et al. Prevention of central venous catheter-related infections by using maximal sterile barrier precautions during insertion. Infect Control Hosp Epidemiol 1994;15:231238.
10.Veenstra, DL, Saint, S, Saha, S, Lumley, T, Sullivan, SD. Efficacy of antiseptic-impregnated central venous catheters in preventing catheter-related bloodstream infection: a meta-analysis. JAMA 1999;281:261267.
11.Moro, ML, Vigano, EF, Cozzi Lepri, A. Risk factors for central venous catheter-related infections in surgical and intensive care units. Infect Control Hosp Epidemiol 1994;15:253264.
12.Eggimann, P, Harbarth, S, Constantin, MN, Touveneau, S, Chevrolet, JC, Pittet, D. Impact of a prevention strategy targeted at vascular-access care on incidence of infections acquired in intensive care. Lancet 2000;355:18641868.
13.Coopersmith, CM, Rebmann, TL, Zack, JE, et al. Effect of an education program on decreasing catheter-related bloodstream infections in the surgical intensive care unit. Crit Care Med 2002;30:5964.
14.Maki, DG, Stolz, SM, Wheeler, S, Mermel, LA. Prevention of central venous catheter-related bloodstream infection by use of an antiseptic-impregnated catheter: a randomized, controlled trial. Ann Intern Med 1997;127:257266.
15.Sherertz, RJ, Ely, EW, Westbrook, DM, et al. Education of physicians-in-training can decrease the risk for vascular catheter infection. Ann Intern Med 2000;132:641648.
16.Timsit, JF. Scheduled replacement of central venous catheters is not necessary. Infect Control Hosp Epidemiol 2000;21:371374.
17.Veenstra, DL, Saint, S, Sullivan, SD. Cost-effectiveness of antiseptic-impregnated central venous catheters for the prevention of catheter-related bloodstream infection. JAMA 1999;282:554560.
18.Mermel, LA, Farr, BM, Sherertz, RJ, et al. Guidelines for the management of intravascular catheter-related infections. Clin Infect Dis 2001;32:12491272.
19.NINSS reports on surgical site infection and hospital acquired bacter-aemia. Commun Dis Rep CDR Wkly 2000;10:213, 216.
20.Lyytikainen, O, Lumio, J, Sarkkinen, H, Kolho, E, Kostiala, A, Ruutu, P. Nosocomial bloodstream infections in Finnish hospitals during 19992000. Clin Infect Dis 2002;35:e14e19.
21.Diekema, DJ, Messer, SA, Brueggemann, AB, et al. Epidemiology of candidemia: 3-year results from the emerging infections and the epidemiology of Iowa organisms study. J Clin Microbiol 2002;40:12981302.
22.O'Grady, NP, Alexander, M, Dellinger, EP, et al. Guidelines for the prevention of intravascular catheter-related infections. Am J Infect Control 2002;30:476489.


Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed