CATheter Infections in CHildren - CATCH

Description:

The goal of the trial was to compare three types of central venous catheters for prevention of bloodstream infections among children admitted to a pediatric intensive care unit (ICU).

Contribution to the Literature: The CATCH trial showed that an antibiotic-impregnated catheter was superior to a standard catheter for prevention of bloodstream infections.

Study Design

  • Randomized
  • Parallel

Patients were randomized to a central venous catheter impregnated with antibiotics (n = 486) vs. a central venous catheter impregnated with heparin (n = 497) vs. a standard central venous catheter (n = 502).

Inclusion criteria:

  • Children <16 years of age admitted to a pediatric ICU with planned insertion of a central venous catheter
  • Total number of enrollees: 1,485
  • Duration of follow-up: 2 days
  • Percentage female: 43%

Principal Findings:

The primary outcome, incidence of bloodstream infection (between 48 hours after randomization and 48 hours after catheter removal) occurred in 1% of the antibiotic-impregnated catheter group vs. 3% of the heparin-impregnated catheter group vs. 4% of the standard catheter group (hazard ratio [HR] for antibiotic or heparin-impregnated catheter vs. standard catheter = 0.71, 95% confidence interval [CI] 0.37-1.34).

Secondary outcomes:

  • HR for antibiotic-impregnated catheter vs. standard catheter = 0.43, 95% CI 0.20-0.96
  • HR for heparin-impregnated catheter vs. standard catheter = 1.04, 95% CI 0.53-2.03

Interpretation:

Among children admitted to a pediatric ICU, an antibiotic-impregnated central venous catheter was superior to a standard central venous catheter at reducing bloodstream infections.  

References:

Gilbert RE, Mok Q, Dwan K, et al., on behalf of the CATCH Trial Investigators. Impregnated central venous catheters for prevention of bloodstream infections in children (the CATCH trial): a randomised controlled trial. Lancet 2016;387:1732-42.

Clinical Topics: Anticoagulation Management, Congenital Heart Disease and Pediatric Cardiology, Diabetes and Cardiometabolic Disease, Invasive Cardiovascular Angiography and Intervention, Prevention, Congenital Heart Disease, CHD and Pediatrics and Arrhythmias, CHD and Pediatrics and Interventions, CHD and Pediatrics and Prevention, Interventions and Structural Heart Disease

Keywords: Anti-Bacterial Agents, Bacteremia, Catheterization, Central Venous, Central Venous Catheters, Child, Heart Defects, Congenital, Heparin, Incidence, Infection, Intensive Care Units, Pediatric, Primary Prevention


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