Keystone ICU Project

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Pronovost P, et al. "An intervention to decrease catheter-related bloodstream infections in the ICU". The New England Journal of Medicine. 2006. 355(26):2725-32.
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Clinical Question

Among ICU patients, does placement of central lines using a standardized protocol reduce rates of catheter-related bloodstream infections?

Bottom Line

Among ICU patients, placement of central lines using a standardized protocol reduces rates of catheter-related bloodstream infections.

Major Points

Guidelines

Design

  • N=
    • (n=)
    • (n=)
  • Setting:
  • Enrollment:
  • Mean follow-up:
  • Analysis:
  • Primary outcome:

Population

Inclusion Criteria

Exclusion Criteria

Baseline Characteristics

Interventions

Outcomes

Median rates presented. P-values are in comparison to baseline rate.

Primary Outcome

CLABSI
Baseline: 2.7/1000 catheter-days
0-3 months: 0/1000 catheter days (P≤0.05)

Secondary Outcomes

CLABSIs beyond 3 months
4-6 months: 0/1000 catheter days (P≤0.002)
7-9 months: 0/1000 catheter days (P≤0.002)
10-12 months: 0/1000 catheter days (P≤0.002)
13-15 months: 0/1000 catheter days (P≤0.002)
16-18 months: 0/1000 catheter days (P≤0.002)

Subgroup Analysis

Adverse Events

 % vs. % (## HR; 95% CI ##-##; P=##; NNH=##)

Criticisms

Funding

Further Reading