Reviewed by Hannah Imlay, MD, MS, University of Utah
A randomized trial of 7 vs 4 days between infusion set replacements among patients with central venous access devices (including tunneled cuffed, non-tunneled, peripherally inserted, and totally implanted) and arterial catheters showed that replacing infusion sets every 7 days was as good as every 4 in preventing CRBSI (adjudicated by blinded infectious diseases physicians).
In total 2944 patients were assigned to 7 vs 4-day infusion set replacement. For central venous access devices, 20/1124 (1.8%) with every 7-day replacement vs 16/1097 (1.5%) with 4-day replacement developed CRBSI. For peripheral arterial catheters, 1/357 (0.28%) with every 7-day replacement vs 0/363 with 4-day replacement developed CRBSI. The 7-day group had mean cost savings of AU$483 (central line) and AU$43 (peripheral arterial catheter). Replacement every 7 days saved 174 min of nursing time for central venous catheters and 7 min for peripheral arterial catheters.
Rickard CM, Marsh NM, Larsen EN, McGrail MR, Graves N, Runnegar N, Webster J, Corley A, McMillan D, Gowardman JR, Long DA, Fraser JF, Gill FJ, Young J, Murgo M, Alexandrou E, Choudhury MA, Chan RJ, Gavin NC, Daud A, Palermo A, Regli A, Playford EG. Effect of infusion set replacement intervals on catheter-related bloodstream infections (RSVP): a randomised, controlled, equivalence (central venous access device)-non-inferiority (peripheral arterial catheter) trial. Lancet. 2021 Apr 17;397(10283):1447-1458. doi: 10.1016/S0140-6736(21)00351-2. PMID: 33865494.