[Intravascular catheter: prevention and therapy of infection]

Intravascular devices are widely used. If certain precautions are taken, catheter-related infections, and especially bacteremia, are infrequent. Special attention should be paid to the correct access (peripheral versus V. subclavia or V. jugularis interna), immediate stabilization of the position, the choice of dry dressings (transparent plastic dressings should be avoided on newly inserted or arterial catheters, as well as on damp wounds), and regular changing of peripheral lines. In the febrile patient with vascular access the infective source should be sought. If the insertion site shows signs of inflammation, or if septicemia occurs, catheters must be removed. In patients with peripheral suppurative thrombophlebitis, surgical excision of the vein must be considered. In contrast, in septic thrombophlebitis of a central vein, removal of the catheter and antibiotic and anticoagulation therapy may be sufficient.