Central Venous Catheter Insertion in Septic Patients Admitted From the Emergency Department: It Is All in the Timing

• Type of Material: Article
• Authors: Rohit Mittal, Emory University; Craig Coopersmith, Emory University
• Language: English
• Date: 2014-03-01
• Publisher: Lippincott, Williams & Wilkins
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: (C) 2014 by the Society of Critical Care Medicine and Lippincott Williams & Wilkins
• Final Published Version (URL): http://dx.doi.org/10.1097/01.ccm.0000435693.15963.60
• Title of Journal or Parent Work: Critical Care Medicine
• ISSN: 0090-3493
• Volume: 42
• Issue: 3
• Start Page: 735
• End Page: 736
• Keywords: SURVIVING SEPSIS; sepsis; Science & Technology; SHOCK; SEVERE SEPSIS; General & Internal Medicine; GUIDELINES; central venous catheter; MANAGEMENT; Life Sciences & Biomedicine; Critical Care Medicine; MORTALITY; intensive care unit; emergency department
• Research Categories: Health Sciences, Health Care Management; Health Sciences, Medicine and Surgery

Abstract

Management of sepsis is time sensitive. The faster therapy is initiated, the higher the likelihood for a positive outcome. While the optimal treatment for severe sepsis and septic shock is multifactorial, a cornerstone of management includes placement of a central venous catheter (CVC) in order to administer vasoactive agents, and measure central venous pressure and central venous oxygenation when appropriate. In this issue of Critical Care Medicine, Theodoro et al examine the utilization and timing of CVCs in patients admitted from the ED with a diagnosis of sepsis or respiratory arrest. A total of 25% of all ED admissions that underwent CVC placement at 310 hospitals in California between 2003 and 2006 were analyzed. Procedures were categorized based on when a CVC was inserted, with insertion on day 0 of hospitalization classified as emergent, insertion on days 1–2 classified as urgent, and insertion on day 3 or beyond classified as late.