Related Experiment Video
Updated: May 13, 2026
09:17
Use of a Central Venous Line for Fluids, Drugs and Nutrient Administration in a Mouse Model of Critical Illness
Published on: May 2, 2017
Utilization patterns and outcomes associated with central venous catheter in septic shock: a population-based study
Allan J Walkey1, Renda Soylemez Wiener, Peter K Lindenauer
1The Pulmonary Center, Division of Pulmonary and Critical Care Medicine, Boston University School of Medicine, Boston, MA, USA. alwalkey@bu.edu
Critical Care Medicine
|March 20, 2013
Summary
Early central venous catheter use in septic shock increased significantly, leading to a notable decrease in hospital mortality. This trend aligns with updated clinical guidelines for septic shock management.
Area of Science:
- Critical Care Medicine
- Vascular Access
- Septic Shock Management
Background:
- Early goal-directed therapy (EGDT) for septic shock, recommended by the Surviving Sepsis Campaign, necessitates central venous catheter (CVC) placement.
- A 2001 trial demonstrated reduced mortality with EGDT in septic shock.
Purpose of the Study:
- To evaluate national trends in CVC utilization for septic shock patients.
- To assess the association between early CVC insertion and hospital mortality in septic shock.
Main Methods:
- Retrospective analysis of non-federal acute care hospitalizations from the Nationwide Inpatient Sample (1998-2009).
- Examined septic shock cases (n=203,481) admitted via emergency departments.
- Compared early (day of admission) CVC insertion rates and associated mortality between 1998-2001 and 2002-2009.
Main Results:
- Septic shock incidence increased from 12.6 to 78 cases per 100,000 U.S. adults (1998-2009).
- Age-adjusted hospital mortality for septic shock declined from 40.4% to 31.4%.
- Early CVC insertion rates rose from 5.7% to 19.2%, with a significant increase observed after 2007.
- Mortality decline was steeper with early CVC insertion (-4.2%/year) compared to no CVC (-2.9%/year; p=0.016).
- Multivariable-adjusted odds ratio for hospital mortality with early CVC decreased from 1.29 (pre-2001) to 0.87 (post-2001).
Conclusions:
- Central venous catheter placement in septic shock has tripled since 1998.
- Mortality associated with early CVC insertion decreased following the dissemination of evidence-based guidelines for its use.
Related Concept Videos
01:27Parentral Nutrition: Centeral and Peripheral Parental Nutrition
Parenteral Nutrition (PN) delivers essential nutrients directly into the bloodstream, bypassing the digestive system. It is commonly used for individuals with severe digestive disorders or conditions that prevent normal nutrient absorption.
PN can be administered through two primary routes:
1. Central Parenteral Nutrition (CPN):
CPN involves delivering a high concentration of nutrients through a large vein. This is typically achieved using a Peripherally Inserted Central Catheter (PICC) or,...
PN can be administered through two primary routes:
1. Central Parenteral Nutrition (CPN):
CPN involves delivering a high concentration of nutrients through a large vein. This is typically achieved using a Peripherally Inserted Central Catheter (PICC) or,...
01:29Venous Thrombosis III: Interprofessional Care
Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...
01:22Aneurysm IV: Nursing Management
Vigilant monitoring for aneurysm rupture is essential for patients undergoing aortic surgery.Preoperative Nursing ManagementContinuously monitor the patient for manifestations of aneurysm rupture, such as pallor, weakness, tachycardia, hypotension, abdominal, back, groin, or periumbilical pain, changes in consciousness, and a pulsating abdominal mass. Regularly assess the patient's peripheral pulses.Instruct the patient to consume a clear liquid diet the day before surgery and administer...
01:20Venous Thrombosis II: Clinical Manifestations and Diagnostic Studies
The key difference between Superficial Vein Thrombosis (SVT) and Deep Vein Thrombosis (DVT) lies in their location and severity.Clinical ManifestationsSVT typically presents with localized pain, tenderness, and redness along the course of a superficial vein, often accompanied by a palpable, cord-like structure under the skin. This condition is usually less dangerous than DVT but can be uncomfortable and may lead to complications such as cellulitis or, rarely, a clot extension into the deep...
01:30Venous Thrombosis IV: Nursing Management
Nursing management begins with a thorough assessment of the patient's health history. Key factors include trauma to veins, peripherally inserted central catheters, varicose veins, recent pregnancy or childbirth, surgery, bacteremia, prolonged bed rest, atrial fibrillation, COPD, heart failure, cancer, coagulation disorders, myocardial infarction, spinal cord injury, stroke, prolonged travel, recent bone fractures, and dehydration. Review medication intake, particularly oral contraceptives,...
01:26Cardiac Catheterization IV: Nursing Management
Nursing responsibilities before cardiac catheterization include:Assess for allergies and establish baseline health status.Before cardiac catheterization, assess the patient for allergies to contrast dye. Perform a comprehensive baseline assessment, including vital signs, heart and breath sounds, and a neurovascular assessment of the extremities, noting distal pulses, skin color, and temperature. Instruct the patient to fast for 8-12 hours before the procedure. Evaluate baseline laboratory...