Bibliographic information
GuidelineGuidelines for the prevention of bloodstream infections and other infections associated with the use of intravascular catheters: part 2: central venous catheters
Year of Publication2026
Issuing InstitutionWorld Health Organization
Recommendation
New
WHO suggests regular changing of the central venous catheter (CVC) administration set (tubing/giving) after administering total parenteral nutrition or lipid products in adults, adolescents, children and neonates. (Short- and long-term catheters) (All population)
Recommended in favor
Conditional
Certainty of evidence
Very low
Notes and Remarks
Some GDG members highlighted that there is indirect evidence about outbreak occurrence when using these products, with total parenteral nutrition and lipid formulations considered as a risk factor for catheter colonization and CLABSI (162-165). Sepsis that can occur in between 20% and 30% of patients receiving parenteral nutrition (162) and microbiological studies suggest microbial growth in lipid formulations (166).
- The GDG did not reach a definitive consensus on recommending a specific schedule based on the evidence provided. However, they noted that a reasonable interval could be within 24 hours of administering lipid products.
- Although the GDG did not recommend a specific schedule, the GDG remarked that regular changing should be done frequently (for example, within 24 hours from administration of lipid products, according to manufacturers’ instructions).
- A sterile technique should be ensured when changing the administration (tubing/giving) set for a CVC.
- It is also acknowledged that multiple factors probably influence the increased risk of sepsis in patients receiving parenteral nutrition and this recommendation should be considered as one of multiple measures to be implemented.