Peripherally inserted central catheters in allogeneic hematopoietic stem cell transplant recipients.
Adult
Catheter-Related Infections
/ etiology
Catheterization, Central Venous
/ adverse effects
Catheterization, Peripheral
/ adverse effects
Central Venous Catheters
/ adverse effects
Female
Hematologic Neoplasms
/ therapy
Hematopoietic Stem Cell Transplantation
/ adverse effects
Humans
Male
Middle Aged
Parenteral Nutrition, Total
/ adverse effects
Polyurethanes
Silicones
Thrombosis
/ etiology
Young Adult
Allogeneic hematopoietic stem cell transplantation
Infections
Mechanical complications
PICC
Thrombosis
Journal
Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer
ISSN: 1433-7339
Titre abrégé: Support Care Cancer
Pays: Germany
ID NLM: 9302957
Informations de publication
Date de publication:
Sep 2020
Sep 2020
Historique:
received:
15
06
2019
accepted:
23
12
2019
pubmed:
5
1
2020
medline:
25
9
2020
entrez:
5
1
2020
Statut:
ppublish
Résumé
Central venous catheters (CVC) are essential for the management of patients with hematologic malignancies, facilitating chemotherapy infusion, antibiotics, parenteral nutrition, blood products, and blood samples collection. In this population, peripherally inserted central catheters (PICC) seem to be associated with lower complications, compared with conventional percutaneously inserted devices (CICC). Data on the PICC in allogeneic hematopoietic stem cell recipients (allo-HSCT) are limited. We have prospectively evaluated the safety and efficacy of 100 polyurethanes or silicone PICC, inserted into 100 adult allo-HSCT recipients, at the Hematology of Sapienza University of Rome (Italy), between October 2012 and August 2017. The median duration of PICC placement was 117 days. Overall, 68% of patients maintained the device for the entire transplant procedure and PICC were removed after day 100 from allo-HSCT; of these, 44% did not experienced any PICC-related complications. Catheter-related bloodstream infections (CRBSI) occurred in 32% of patients (2.5/1000 PICC days), associated with thrombosis in 8 cases. CRBSI were observed in 42% of patients with polyurethane and 20% with silicone PICC (p = 0.02). Catheter-related thrombosis occurred in 9% of patients, never requiring anticipated PICC removal. Mechanical complications occurred in 15% of cases (1.2/1000 PICC days). On the whole, adverse events were manageable and did not affect transplant outcome. No deaths related to PICC-complications were observed. PICC are a safe and reliable long-term venous access in allo-HSCT recipients.
Sections du résumé
BACKGROUND
BACKGROUND
Central venous catheters (CVC) are essential for the management of patients with hematologic malignancies, facilitating chemotherapy infusion, antibiotics, parenteral nutrition, blood products, and blood samples collection. In this population, peripherally inserted central catheters (PICC) seem to be associated with lower complications, compared with conventional percutaneously inserted devices (CICC). Data on the PICC in allogeneic hematopoietic stem cell recipients (allo-HSCT) are limited.
METHODS
METHODS
We have prospectively evaluated the safety and efficacy of 100 polyurethanes or silicone PICC, inserted into 100 adult allo-HSCT recipients, at the Hematology of Sapienza University of Rome (Italy), between October 2012 and August 2017.
RESULTS
RESULTS
The median duration of PICC placement was 117 days. Overall, 68% of patients maintained the device for the entire transplant procedure and PICC were removed after day 100 from allo-HSCT; of these, 44% did not experienced any PICC-related complications. Catheter-related bloodstream infections (CRBSI) occurred in 32% of patients (2.5/1000 PICC days), associated with thrombosis in 8 cases. CRBSI were observed in 42% of patients with polyurethane and 20% with silicone PICC (p = 0.02). Catheter-related thrombosis occurred in 9% of patients, never requiring anticipated PICC removal. Mechanical complications occurred in 15% of cases (1.2/1000 PICC days). On the whole, adverse events were manageable and did not affect transplant outcome. No deaths related to PICC-complications were observed.
CONCLUSIONS
CONCLUSIONS
PICC are a safe and reliable long-term venous access in allo-HSCT recipients.
Identifiants
pubmed: 31900609
doi: 10.1007/s00520-019-05269-z
pii: 10.1007/s00520-019-05269-z
doi:
Substances chimiques
Polyurethanes
0
Silicones
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM