Prospective Randomized Controlled Multicenter Trial of 4 Antiseptic Strategies for Prevention of Catheter Infection in Intensive Care Unit for Adults Patients (CLEAN)
Catheter related infection is the third cause of nosocomial infection in ICUs. Most of them are avoidable and can be prevent by improving aseptic practices during catheter insertion and maintenance. Indeed, the main route of catheter contamination for short-term catheters is the insertion site. Consequently, the quality of skin disinfection is the most effective preventive measure to reduce the incidence of these infections.
This aim of the present study is to compare four strategies of skin disinfection to determine whether a 2% alcoholic solution of chlorhexidine acts better than 5% alcoholic povidone iodine in reducing catheter infection and to assess whether a detersion phase prior to disinfection reduces catheter colonization as compared with no detersion.
調査の概要
研究の種類
入学
段階
- フェーズ 4
連絡先と場所
研究場所
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-
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Angers、フランス、49933
- Angers University Hospital
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Clermont-Ferrand、フランス、63000
- Estain University Hospital
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Paris、フランス、75018
- Bichat-Claude Bernard Hospital
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Pierre Benite、フランス、69465
- Lyon university hospital
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Poitiers、フランス、86021
- Poitiers university hospital
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参加基準
適格基準
就学可能な年齢
健康ボランティアの受け入れ
受講資格のある性別
説明
Inclusion Criteria:
- ≥ 18 year-old
- Expected duration of ICU stay ≥ 48 hours
- Patient requiring the insertion of at least one arterial catheter and/or central venous catheter and/or catheter for hemodialysis.
Exclusion Criteria:
- Patient with history of allergy to any of the antiseptic agent studied
- Expected survival < 48 hours
- Catheter inserted outside the ICU or in emergency without respect of preventive measures.
- Use of antimicrobial impregnated catheters or antiseptic impregnated dressings.
- Pregnant woman or breast-feeding mother
研究計画
研究はどのように設計されていますか?
デザインの詳細
- 主な目的:防止
- 割り当て:ランダム化
- 介入モデル:並列代入
- マスキング:なし(オープンラベル)
武器と介入
参加者グループ / アーム |
介入・治療 |
---|---|
アクティブコンパレータ:PVI paint
5% alcoholic povidone iodine paint
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アクティブコンパレータ:PVI scrub and paint
detersion with 4% povidone iodine scrub followed by 5% alcoholic povidone iodine paint
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|
アクティブコンパレータ:Chlorhexidine paint
2% alcoholic chlorhexidine paint
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アクティブコンパレータ:chlorhexidine scrub and paint
Detersion with 4% chlorhexidine scrub followed 2% alcoholic chlorhexidine paint
|
この研究は何を測定していますか?
主要な結果の測定
結果測定 |
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Major catheter related infection
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二次結果の測定
結果測定 |
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費用
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カテーテル定着
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Catheter related bacteremia
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Colonization insertion site
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Prolongation hospitalization due to catheter infection
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Mortality due to catheter infection
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Skin allergy and anaphylactic shock
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協力者と研究者
出版物と役立つリンク
一般刊行物
- Iachkine J, Buetti N, de Grooth HJ, Briant AR, Mimoz O, Megarbane B, Mira JP, Ruckly S, Souweine B, du Cheyron D, Mermel LA, Timsit JF, Parienti JJ. Development and validation of a multivariable prediction model of central venous catheter-tip colonization in a cohort of five randomized trials. Crit Care. 2022 Jul 7;26(1):205. doi: 10.1186/s13054-022-04078-x.
- Buetti N, Ruckly S, Lucet JC, Bouadma L, Schwebel C, Mimoz O, Timsit JF. Ultrasound guidance and risk for intravascular catheter-related infections among peripheral arterial catheters: a post-hoc analysis of two large randomized-controlled trials. Ann Intensive Care. 2020 Jul 8;10(1):89. doi: 10.1186/s13613-020-00705-4.
- Maunoury F, Farinetto C, Ruckly S, Guenezan J, Lucet JC, Lepape A, Pascal J, Souweine B, Mimoz O, Timsit JF. Cost-effectiveness analysis of chlorhexidine-alcohol versus povidone iodine-alcohol solution in the prevention of intravascular-catheter-related bloodstream infections in France. PLoS One. 2018 May 25;13(5):e0197747. doi: 10.1371/journal.pone.0197747. eCollection 2018.
- Mimoz O, Lucet JC, Kerforne T, Pascal J, Souweine B, Goudet V, Mercat A, Bouadma L, Lasocki S, Alfandari S, Friggeri A, Wallet F, Allou N, Ruckly S, Balayn D, Lepape A, Timsit JF; CLEAN trial investigators. Skin antisepsis with chlorhexidine-alcohol versus povidone iodine-alcohol, with and without skin scrubbing, for prevention of intravascular-catheter-related infection (CLEAN): an open-label, multicentre, randomised, controlled, two-by-two factorial trial. Lancet. 2015 Nov 21;386(10008):2069-2077. doi: 10.1016/S0140-6736(15)00244-5. Epub 2015 Sep 18.
- Goudet V, Timsit JF, Lucet JC, Lepape A, Balayn D, Seguin S, Mimoz O. Comparison of four skin preparation strategies to prevent catheter-related infection in intensive care unit (CLEAN trial): a study protocol for a randomized controlled trial. Trials. 2013 Apr 27;14:114. doi: 10.1186/1745-6215-14-114.
研究記録日
主要日程の研究
研究開始
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (見積もり)
学習記録の更新
投稿された最後の更新 (見積もり)
QC基準を満たした最後の更新が送信されました
最終確認日
詳しくは
本研究に関する用語
追加の関連 MeSH 用語
その他の研究ID番号
- CLEAN
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