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 using either a continuous IV infusion or an intermittent infusion for the maintenance of central venous catheters (CVCs) 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
- The GDG defined a “continuous infusion” as an uninterrupted IV administration over an extended period during the day, whereas an “intermittent infusion” involves breaks and interruptions in the flow.
- The choice of continuous versus intermittent infusion will often depend on the clinical settings (that is, ICU versus non-ICU), the requirements of the treatment regimen being administered, and the patient’s clinical conditions (that is, mobile versus bedbound patient; critically ill versus non-critically ill patient).
- GDG members noted that neither continuous infusion nor intermittent infusion schedules have been associated with the prevention of CLABSI. Continuous infusion may reduce the risk of noninfection-related phlebitis, occlusion and thrombosis, depending on the drugs administered via the catheter. However, it may also increase the risk of fluid overload and incur additional costs. Other GDG members pointed out that intermittent infusion requires more frequent manipulation of the catheter, potentially increasing the risk of infection. These factors should be considered when choosing the type of infusion.
- Regardless of the infusion type used, it is crucial to train health care personnel on aseptic techniques when accessing the CVC line. If the catheter is to be maintained using a continuous infusion, it should be administered according to a clearly-defined protocol. However, caution should be used when adopting a protocol of continuous fluid infusion for catheter maintenance to avoid excessive fluid being administered and resulting in potential fluid overload of the patient.
- Where feasible, the patient’s preferences should also be considered when deciding the type of infusion to be administered.