Rate of colonization of Internal Jugular and Femoral Central Venous Catheters in Medical Intensive Care Unit and Medical High Dependency Unit

OBJECTIVES: To assess the colonization rate and catheter related bloodstream infection rate of internal jugular and femoral central venous catheters in Medical Intensive Care Unit and Medical High Dependency Unit. METHODS: Single blinded randomized controlled trial where the site of central venous catheter insertion was determined by randomization. There were 2 arms with equal allocation – internal jugular and femoral. Inclusion criteria: All patients in Medical Intensive Care Unit / Medical High Dependency Unit who require insertion of a central venous catheter. Exclusion criteria: 1. Deep vein thrombosis, 2. Cardiac arrest in the last 24 hours, 3. Patients who do not give consent, 4. Pregnant women, 5. Immunocompromised patients, 6. Severe coagulopathy, 7. Skin lesion, 8. Profound volume overload. Primary Outcome: Colonization rate of central venous catheter tip in the jugular and femoral group. Secondary outcome: Catheter Related Bloodstream Infection rate in patients with jugular and femoral central venous catheters. RESULTS: The colonization rate in the internal jugular and the femoral group was 20.5% and 23.9% respectively. This difference was not statistically significant. More patients need to be included in the study to draw clinical implications. There were 3 catheter related bloodstream infections among the patients included in the study. All 3 infections were in the femoral group. There is a trend towards higher number of catheter related bloodstream infections in the femoral group in spite of similar colonization rates