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 & Pediatrics and Arrhythmias, CHD & Pediatrics and Interventions, CHD & 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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