Table 3.

Prevention of dialysis catheter infection

Choice of the dialysis catheter
Lumens	No difference between dual lumen catheter and two single lumen catheters placed side by side in terms of infection
Tunnelization	Not recommended for initiating RRT
Antimicrobial-coated catheters	Use not currently recommended and should be limited to units with high rates of DC infections despite implementation of adequate preventive strategies
Choice of the insertion site
	No difference between femoral or jugular sites in term of infection.
	Physicians should be vigilant with femoral site in case of high body mass index, and with internal jugular site in case of low body mass index
Insertion procedures
Hygiene procedure	Surgical hand disinfection
Depilation	Wear a long-sleeved sterile gown, sterile gloves, and cap
	Use a large sterile drape
	If hairs disturb vascular puncture or dressing occlusion
Skin preparation	>0.5% alcoholic chlorhexidine or alcoholic povidone iodine
Antibiotic prophylaxis Ultrasound guidance	Not recommended. May be proposed for internal jugular DC placement
During RRT
Hygiene procedure	Use strict aseptic conditions for every DC manipulation
Dressing	Limit manipulation
	Avoid use of dialysis catheter for perfusion or blood samples, except in case of life threatening emergency
	Semipermeable transparent polyurethane dressing, sterile gauze
Antimicrobial lock solutions	Before applying a new dressing, clean skin with antiseptic solution, 0.5% alcoholic chlorhexidine or alcoholic povidone iodine
	Change in case of disruption or soiled dressing
	Change dressings at every dialysis
	Not recommended for prevention
Local ointments	Not recommended for ICU dialysis catheter
Catheter	Catheter replacement not scheduled
	Limit indwelling time and remove as soon as unnecessary