Systematic review of emergency department central venous and arterial XXXX .

@entity281 @entity1212 @entity455
BACKGROUND: There is an extensive critical care literature for central @entity455 , duration of catheterization, and compliance with @entity281 control procedures. The emergency medicine literature, however, contains very little data on central venous catheters and arterial lines. As emergency medicine practice continues to incorporate greater numbers of critical care procedures such as central venous catheter placement, @entity281 control is becoming a greater issue. AIMS: We performed a systematic review of studies reporting baseline data of ED-placed central venous catheters and arterial lines using multiple search methods. METHODS: Two reviewers independently assessed included studies using explicit criteria, including the use of ED-placed invasive lines, the presence of central line-associated @entity281 , and excluded case reports and review articles. Finding significant heterogeneity among studies, we performed a qualitative assessment. RESULTS: Our search produced 504 abstracts, of which 15 studies were evaluated, and 4 studies were excluded because of quality issues leaving 11 cohort studies. Four studies calculated @entity281 rates, ranging 0-24.1/1,000 catheter-days for central line-associated and 0-32.8/1,000 catheter-days for central line-related @entity281 . Average duration of catheterization was 4.9  days (range 1.6-14.1  days), and compliance with @entity281 control procedures was 33-96.5%. The data were too poor to compare emergency department to in-hospital @entity1212 rates. CONCLUSIONS: The existing data for emergency department-placed invasive lines are poor, but suggest they are a source of @entity281 , remain in place for a significant period of time, and that adherence to maximum barrier precautions is poor. Obtaining accurate rates of @entity281 and comparison between emergency department and inpatient lines requires prospective study.
