Interventions for preventing infectious complications in haemodialysis patients with central venous lines

Patients whose kidneys no longer work need to have water, toxins and other chemicals removed from their blood using an artificial kidney. One method of achieving this is to use a central venous catheter (CVC) which is a small tube inserted via the skin into a blood vessel in the neck of the patient. This tube allows blood to go from the patient, pass through an artificial kidney and return back to the patient. This process is referred to as a dialysis session which takes four hours and is usually performed three times a week. As CVC have direct access to the blood system they can cause serious infections which can be life threatening to the patient. Several strategies can be used to prevent these infections occurring including the application of different types of ointments (mupirocin, povidone-iodine and polysporin) or medicinal honey to the catheter site, and the use of different dressings which cover the catheter site (transparent or gauze and tape). The review of 10 studies (786 patients) found that mupirocin ointment reduced the risk of patients developing catheter-related bacteraemia (bacteria in the blood). However, monitoring of mupirocin resistance needs to be considered in future studies. There was not enough evidence to determine which ointment (povidone-iodine and polysporin) or dressing was the best in preventing infection. There was also insufficient evidence to support the use of medicinal honey for the prevention of infection.