Preventing CVAD Infections: What Should We Test Next?

Central venous access devices (CVADs) are essential in healthcare but come with a serious risk: bloodstream infections. With so many potential interventions—and limited high-quality evidence—what should we test next?

To answer this, researchers conducted a prioritisation study with infection control professionals across Australasia, setting the stage for the upcoming IVCare adaptive platform trial, which aims to evaluate the best ways to prevent CVAD-related bloodstream infections (CLABSIs).

Top 5 Priorities for Future Clinical Trials:

• Education & competency assessment for CVAD insertion and care
• Vascular access teams to oversee insertion and post-insertion care
• Sutureless securement devices
• Mechanical decontamination of catheter access points
• Antiseptic-containing hubs/connectors

While some of these interventions are already in limited use, this study found no hospital was using all of them consistently, highlighting clinical variation and the need for stronger evidence.

Why It Matters

• CLABSIs are life-threatening and costly.
• Most current practices rely on expert opinion or limited studies—not gold-standard RCTs.
• Adaptive platform trials like IVCare can test multiple interventions efficiently and simultaneously.

What’s Next?

This study confirms strong clinician support and clinical equipoise for trials of these interventions. The authors call for a perpetual trial framework that includes diverse clinical voices and patient perspectives—ensuring better, safer vascular access care.

Read More:  https://doi.org/10.1016/j.ajic.2025.06.003

Authors:  Claire M. Rickard, Andrew J. Stewardson, Sally M. Havers, Niccolo Buetti, Kevan R. Polkinghorne, Aleece MacPhail, Zoe McQuilten, Benjamin Lazarus, Karina R. Charles, Jessica A. Schults