Interventions for the management of central venous line’s infections in pediatric intensive care units: Systematic Review

Introduction: Central Venous Catheters (CVC) are an important part of patient care, allowing the administration of intravenous fluids, blood, drugs and parenteral solutions. Their use is a cause of infections due to micro-organisms colonizing the skin at the entry point or the catheter or other point along it or the fluids administered by the Intensive Care Unit (ICU). Central line-associated bloodstream infections (CLABSI’s) in children's ICUs are an important factor that negatively affects the course of the disease, causing complications, perhaps irreversible. Aim: The aim of this study was to investigate the interventions for the management of CLABSI’s in neonatal and pediatric ICUs. Methodology: Published research articles in the years 2016-2021 in valid scientific journals referring to children with CVC hospitalized in neonatal and pediatric ICUs were studied. A systematic search of the literature was performed in digital scientific databases (Medline, PubMed Scopus, Embase, Cochrane Library) using keywords. The PICOS (Population, Interventions, Controls, Outcome, Study design) procedure was used as a criterion for the inclusion of an article in the present study. The evaluation of the articles of the bibliographic search were evaluated using the PRISMA method. Results – Discussion: Interventions for the management of CLABSI’s included the use of chlorhexidine-soaked pads, implementation of measures to prevent CLABSI’s, use of a pre-filled disposable syringe for flushing, implementation of an infection surveillance system, use of new methods/measures for introduction, use and management of CVCs, use of ethanol lock, use of antibiotic-impregnated CVCs and multidimensional approaches. Conclusions: As it was seen from the results of the study, there are several research evidence regarding the effectiveness of nursing interventions to limit CLABSI’s in neonatal and children's ICUs. Nevertheless, it seems that prevention measures for CLABSI’s and hand hygiene guidelines have a decisive role in limiting CLABSI’s in neonatal and pediatric ICUs.

Keywords: Bloodstream infections, pediatric intensive care units, neonatal intensive care units, nursing, central line-associated bloodstream infection, central venous lines