Prospective nonrandomized trial of silver impregnated cuff central lines

Central venous lines were used to administer total parenteral nutrition at our institution. In an attempt to reduce line sepsis, silver impregnated cuff central lines (Hohn catheter) were adopted as standard of practice. Using a comprehensive morbidity and mortality database, 134 patients with Hohn catheters were compared to 252 patients who had polypropylene central line. The incidence of central line sepsis was increased with Hohn catheters to 23 of 134 (17.2%). This compared to 8 of 252 (3.2%) patients with polypropylene catheters (P < 0.0001). Also, an increased incidence of pulmonary embolism of 15 of 134 (11.2%) in patients with Hohn catheters was observed as compared to 2 of 252 (0.8%) with a polypropylene catheter (P < 0.0001). Insertion of Hohn catheters through the intrajugular vein was judged to be more difficult than polypropylene catheters. This may cause increased trauma to the vein resulting in a higher incidence of line infection and pulmonary embolism.