Efectividad en el manejo de catéter venoso central por el personal de enfermería en las unidades de cuidados intensivos. Revisión sistemática integrativa
Resumen
INTRODUCCIÓN: El manejo efectivo del catéter venoso central en UCI por el personal de enfermería reduce complicaciones y optimiza la atención, aunque enfrenta retos como la variabilidad en la formación y la adherencia a protocolos. OBJETIVO: Analizar la evidencia científica sobre la efectividad en el manejo del catéter venoso central por el personal de enfermería en las unidades de cuidados intensivos y su impacto en la prevención de complicaciones asociadas. METODOLOGÍA: Revisión sistemática integrativa basada en la declaración PRISMA. Se buscaron estudios en Elsevier, PubMed, Scopus, Scielo, SageJournal, Redalyc, usando términos MESH/DECS y operadores booleanos. Se incluyeron publicaciones de 2020 a 2025 en inglés, español y portugués. RESULTADOS: Se identificaron 156 artículos en las bases de datos Elsevier, PubMed, Scopus, Scielo, SageJournal y Redalyc. Tras eliminar duplicados, se seleccionaron 30 estudios para la revisión. Existen varios factores que afectan el manejo seguro del catéter venoso central. Se revela que la falta de capacitación del personal, limita la correcta aplicación de protocolos de inserción y mantenimiento. A pesar de que las buenas prácticas como la higiene de manos, el uso de antisépticos y la evaluación continua del catéter son esenciales, se observan fallas en la implementación de estos procedimientos y en la documentación adecuada. CONCLUSIONES: La efectividad en el manejo del catéter venoso central depende del cumplimiento de protocolos, la capacitación y la supervisión del personal de enfermería. La rotación laboral y la sobrecarga de trabajo pueden reducir la adherencia a las medidas de seguridad, aumentando el riesgo de complicaciones.
Descargas
Citas
Abdelghafour, A. M., Sayed Gad, G., Abdelbaky, M. M., & Mohammed, R. F. (2021). Asmaa M., et al Nursing Guidelines and its Effect on Reducing Central Line Related Infection among Traumatic Patients. Minia Scientific Nursing Journal (Print-), 10, 148.
Alsaleh, K., Alosaimi, D., Almousawi, A., Alshaikh, M., & Omar, H. (2024). Effectiveness of a nurse-led peripherally inserted central catheter service: A retrospective cohort study. The Journal of Vascular Access. https://doi.org/10.1177/11297298241263886
Buetti, N., & Timsit, J. F. (2020). Management and Prevention of Central Venous Catheter-Related Infections in the ICU. Seminars in Respiratory and Critical Care Medicine, 40(4), 508–523. https://doi.org/10.1055/S-0039-1693705
Chi, X. W., He, R., Wu, X. H., Wu, L. J., Yang, Y. L., & Huang, Z. (2024). Development of best evidence-based practice protocols for central venous catheter placement and maintenance to reduce CLABSI. Medicine, 103(27), e38652. https://doi.org/10.1097/MD.0000000000038652
Chittick, P., & Sherertz, R. J. (2020). Recognition and prevention of nosocomial vascular device and related bloodstream infections in the intensive care unit. Critical Care Medicine, 38(8 Suppl). https://doi.org/10.1097/CCM.0B013E3181E6CDCA
Cohen, R., Lipman-Arens, S., Mahamid, L., Ishay, L., Feld Simon, O., Reisfeld, S., Ben-Natan, O., Vaknin, A., Ganayem, M., Abu Hadba, R., Karisi, E., Melnik, N., Freimann, S., Shapira, M., Avshovich, N., Darawshe, A., Rachmilevitch, R., Istomin, V., Abilevitch, R., … Tannous, E. (2025). Targeting prolonged short-term central venous catheters to reduce hospital-wide catheter days and CLABSI rates. American Journal of Infection Control, 53(3). https://doi.org/10.1016/J.AJIC.2024.10.011
Conceição, S., Bertoncello, K. C. G., Vieira, G. T., Colaço, A. D., Schneider, D. G., Costa, I. A. P., Fern, J., Nobrega, es da, Souza, A. C. R. H., Teixeira, E. P., Fern, A. E., Chipindo, o, Andrade, Z. B. De, Rodrigues, D. B., Bentes, C. M. L., & Souza, M. D. L. De. (2020). Nursing Care for Patients with Central Venous Catheter: A Systematic Review and Meta-Analysis. Research & Reviews: Journal of Nursing and Health Sciences, 7(1), 1–11. https://www.rroij.com/open-access/nursing-care-for-patients-with-central-venous-catheter-a-systematic-review-and-metaanalysis.php?aid=89032
Dekker, M., Jongerden, I. P., & van Mansfeld, R. (2024). Implementation of infection prevention in intensive and critical care: What an infection control link nurse can contribute. Intensive and Critical Care Nursing, 83, 103705. https://doi.org/10.1016/J.ICCN.2024.103705
Der Kooi, T., Sax, H., Pittet, D., van Dissel, J., van Benthem, B., Walder, B., Cartier, V., Clack, L., de Greeff, S., Wolkewitz, M., Hieke, S., Boshuizen, H., van de Kassteele, J., Van den Abeele, A., Boo, T. W., Diab-Elschahawi, M., Dumpis, U., Ghita, C., FitzGerald, S., … Zingg, W. (2020). Prevention of hospital infections by intervention and training (PROHIBIT): results of a pan-European cluster-randomized multicentre study to reduce central venous catheter-related bloodstream infections. Intensive Care Medicine, 44(1), 48–60. https://doi.org/10.1007/S00134-017-5007-6
Echanove, J., Edwards, J. R., Richards, M. J., Brennan, P., Venezia, R. A., Keen, J., Ashline, V., Kirkland, K., Chou, E., Hupert, M., Veeder, A. V., Speas, J., Kaye, J., Sharma, K., Martin, A., Moroz, V. D., & Gaynes, R. P. (2020). Effect of nurse staffing and antimicrobial-impregnated central venous catheters on the risk for bloodstream infections in intensive care units. Infection Control and Hospital Epidemiology, 24(12), 916–925. https://doi.org/10.1086/502160
García, J. B., Maldonado, C. J. Q., Iza, M. M. H., & Medina, R. E. R. (2024). Rol de enfermería en gestión, instalación y mantenimiento en los accesos vasculares y su uso correcto en terapia de infusión. RECIAMUC, 8(2), 914–925.
https://doi.org/10.26820/RECIAMUC/8.(2).ABRIL.2024.914-925
Gonçalves, S., & Santos, M. (2023). Preventive measures for primary bloodstream infection associated with central venous catheters. Research, Society and Development, 12(7), e12112742613–e12112742613. https://doi.org/10.33448/RSD-V12I7.42613
Hanauer, L. P. T., Comerlato, P. H., Papke, A., Butzke, M., Daga, A., Hoffmeister, M. C., Boniatti, M. M., John, J. F., Schaan, B. D., & Rados, D. V. (2020). Reducing central vein catheterization complications with a focused educational program: a retrospective cohort study. Scientific Reports, 10(1). https://doi.org/10.1038/S41598-020-74395-0
Huang, H., Chang, Q., Zhou, Y., & Liao, L. (2024). Risk factors of central catheter bloodstream infections in intensive care units: A systematic review and meta-analysis. PloS One, 19(4). https://doi.org/10.1371/JOURNAL.PONE.0296723
Inocencio, A., Dorociaki, G., Cristoff, C., Bonfim, C., Marçal, A., & Saidelles, B. (2022). Adherence to central venous catheter maintenance bundle in an intensive care unit. Revista Da Escola de Enfermagem Da U S P, 56. https://doi.org/10.1590/1980-220X-REEUSP-2022-0077EN
Jesus, S. C. De, Bertoncello, K. C. G., Vieira, G. T., Colaço, A. D., Schneider, D. G., Costa, I. A. P., Fern, J., Nobrega, es da, Souza, A. C. R. H., Teixeira, E. P., Fern, A. E., Chipindo, o, Andrade, Z. B. De, Rodrigues, D. B., Bentes, C. M. L., & Souza, M. D. L. De. (2020). Nursing Care for Patients with Central Venous Catheter: A Systematic Review and Meta-Analysis. Research & Reviews: Journal of Nursing and Health Sciences, 7(1), 1–11. https://www.rroij.com/open-access/nursing-care-for-patients-with-central-venous-catheter-a-systematic-review-and-metaanalysis.php?aid=89032
Karapanou, A., Vieru, A. M., Sampanis, M. A., Pantazatou, A., Deliolanis, I., Daikos, G. L., & Samarkos, M. (2020). Failure of central venous catheter insertion and care bundles in a high central line-associated bloodstream infection rate, high bed occupancy hospital. American Journal of Infection Control, 48(7), 770–776. https://doi.org/10.1016/J.AJIC.2019.11.018
Levit, O., Shabanova, V., & Bizzarro, M. (2020). Impact of a dedicated nursing team on central line-related complications in neonatal intensive care unit. The Journal of Maternal-Fetal & Neonatal Medicine : The Official Journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians, 33(15), 2618–2622. https://doi.org/10.1080/14767058.2018.1555814
Lok, C. E., Huber, T. S., Lee, T., Shenoy, S., Yevzlin, A. S., Abreo, K., Allon, M., Asif, A., Astor, B. C., Glickman, M. H., Graham, J., Moist, L. M., Rajan, D. K., Roberts, C., Vachharajani, T. J., & Valentini, R. P. (2020). KDOQI Clinical Practice Guideline for Vascular Access: 2019 Update. American Journal of Kidney Diseases : The Official Journal of the National Kidney Foundation, 75(4 Suppl 2), S1–S164. https://doi.org/10.1053/J.AJKD.2019.12.001
Morris, K. Y., & Jakobsen, R. (2022). Central venous catheter access and procedure compliance: A qualitative interview study exploring intensive care nurses’ experiences. Intensive and Critical Care Nursing, 69, 103182. https://doi.org/10.1016/J.ICCN.2021.103182
Najm, A. M. A., & Yasir, A. A. (2024). Nurses’ Practices Concerning Infection Control Measures in Intensive Care Units. Iranian Journal of War and Public Health, 16(2), 175–180. https://doi.org/10.58209/IJWPH.16.2.175
Nunes, J., Faria, M., Vieira, F., & Ferreira, F. (2021). Atuação do enfermeiro na prevenção da infecção associada a Cateter Venoso Central (CVC)/ Nurse’s performance in the prevention of infection associated with Central Venous Catheter (CVC). Brazilian Journal of Health Review, 4(3), 12328–12345. https://doi.org/10.34119/BJHRV4N3-209
Patel, N., Petersen, T. L., Simpson, P. M., Feng, M., & Hanson, S. J. (2020). Rates of Venous Thromboembolism and Central Line-Associated Bloodstream Infections Among Types of Central Venous Access Devices in Critically Ill Children. Critical Care Medicine, 48(9), 1340–1348. https://doi.org/10.1097/CCM.0000000000004461
Rateb, H. R., & McDowell, J. R. S. (2020). Minimising central line-associated bloodstream infection rate in inserting central venous catheters in the adult intensive care units. Journal of Clinical Nursing, 26(23–24), 3962–3973. https://doi.org/10.1111/JOCN.13824
Ricard, J. D., Salomon, L., Boyer, A., Thiery, G., Meybeck, A., Roy, C., Pasquet, B., Le Mière, E., & Dreyfuss, D. (2020). Central or peripheral catheters for initial venous access of ICU patients: a randomized controlled trial. Critical Care Medicine, 41(9), 2108–2115. https://doi.org/10.1097/CCM.0B013E31828A42C5
Salgado Yepez, E., Flores, H. A. G., Valencia, F., Ramirez, V., Lascano, M., Bovera, M. M., Pazmiño, L., Alquinga, N., Jara, E., Delgado, V., Santacruz, G., Zaruma, C., Pinto, D. B., De Los Valles, H., Rosenthal, V. D., Cevallos, C., & Pelaéz, C. (2020). Device-associated infection rates, mortality, length of stay and bacterial resistance in intensive care units in Ecuador: International Nosocomial Infection Control Consortium’s findings. World Journal of Biological Chemistry, 8(1), 95. https://doi.org/10.4331/WJBC.V8.I1.95
Sanlı, D., Sarıkaya, A., & Pronovost, P. J. (2023). Effects of the care given to intensive care patients using an evidence model on the prevention of central line-associated bloodstream infections. International Journal for Quality in Health Care : Journal of the International Society for Quality in Health Care, 35(4). https://doi.org/10.1093/INTQHC/MZAD104
Sharma, R., Gandhi, K. A., Biswal, M., Kaur, K., Sahni, N., & Yaddanapudi, L. (2024). Effect of intensive training and education of health care workers on the maintenance bundle of venous access devices in critically ill patients at a tertiary care academic hospital. American Journal of Infection Control, 52(1), 41–45. https://doi.org/10.1016/J.AJIC.2023.07.002
Stewart, A. G., Laupland, K. B., & Tabah, A. (2023). Central line associated and primary bloodstream infections. Current Opinion in Critical Care, 29(5), 423–429.
https://doi.org/10.1097/MCC.0000000000001082
Thandar, M. M., Rahman, M. O., Haruyama, R., Matsuoka, S., Okawa, S., Moriyama, J., Yokobori, Y., Matsubara, C., Nagai, M., Ota, E., & Baba, T. (2022). Effectiveness of Infection Control Teams in Reducing Healthcare-Associated Infections: A Systematic Review and Meta-Analysis. International Journal of Environmental Research and Public Health, 19(24). https://doi.org/10.3390/IJERPH192417075
Vilão, A., Castro, C., & Fernandes, J. B. (2024). Nursing Interventions to Prevent Complications in Patients with Peripherally Inserted Central Catheters: A Scoping Review. Journal of Clinical Medicine, 14(1). https://doi.org/10.3390/JCM14010089
Xiong, Z., & Chen, H. (2020). Interventions to reduce unnecessary central venous catheter use to prevent central-line-associated bloodstream infections in adults: A systematic review. Infection Control and Hospital Epidemiology, 39(12), 1442–1448. https://doi.org/10.1017/ICE.2018.250
Yugcha, G., & Toala, A. (2023). Evaluación del manejo del Catéter Percutáneo y complicaciones en neonatos en una Unidad de Cuidados Intensivos de Ecuado. Arch Hosp Univ "Gen Calixto García”, 11. https://revcalixto.sld.cu/index.php/ahcg/article/view/e1173/974
Zang, F., Liu, J., Wen, Y., Jin, X., Yang, Y., Li, L., Di, J., Tang, H., Wu, J., Liu, H., Huang, J., Zhang, J., Li, S., Yang, L., Wang, X., Geng, S., Xing, H., Xie, J., Hua, J., … Chen, W. (2024). Adherence to guidelines and central-line-associated bloodstream infection occurrence during insertion and maintenance of intravascular catheters: evidence from 20 tertiary hospitals. The Journal of Hospital Infection, 150, 17–25. https://doi.org/10.1016/J.JHIN.2024.05.011
Zingg, W., Cartier, V., Inan, C., Touveneau, S., Theriault, M., Gayet-Ageron, A., Clergue, F., Pittet, D., & Walder, B. (2020). Hospital-wide multidisciplinary, multimodal intervention programme to reduce central venous catheter-associated bloodstream infection. PloS One, 9(4). https://doi.org/10.1371/JOURNAL.PONE.0093898
Derechos de autor 2025 Linda Michelle Zambrano Camacho , Daniel Santiago Casagallo Quishpi , Inés Patricia Urgilés Vallejo
Esta obra está bajo licencia internacional Creative Commons Reconocimiento 4.0.
.png)
.png)
1.png)
