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Darren White, Scott C Woller, Scott M Stevens, Dave S Collingridge, Vineet Chopra, Gabriel V Fontaine
BACKGROUND: Central venous catheters (CVC) and peripherally inserted central catheters (PICCs) are central vascular access devices (CVADs) that facilitate administration of medications among critically ill patients. Both are associated with risk of venous thromboembolism (VTE). The relative risk of VTE between these catheter types is not well defined. We report the rate of VTE in intensive care unit (ICU) medical patients receiving PICC, CVC, both, or neither. METHODS: We conducted a single-center, retrospective cohort study of medical-ICU patients between November 2007 and November 2013 grouped by receipt of CVC, PICC, both, or neither...
October 19, 2018: Thrombosis Research
Saurabh Zanwar, Punit Jain, Anant Gokarn, Santhosh Kumar Devadas, Sachin Punatar, Sachin Khurana, Avinash Bonda, Ritesh Pruthy, Vivek Bhat, Sajid Qureshi, Navin Khattry
Central venous catheters (CVCs) represent a significant source of infection in patients undergoing hematopoietic stem cell transplantation and can add to the cost of care, morbidity, and mortality. Organisms forming biofilms on the inner surface of catheters require a much higher local antibiotic concentration to clear the pathogen growth. Antibiotic lock therapy (ALT) represents one such strategy to achieve such high intraluminal concentrations of antibiotics and can facilitate catheter salvage. Patients with catheter colonization (CC) or hemodynamically stable catheter-related bloodstream infection (CRBSI) received ALT per institutional policy...
October 27, 2018: Transplant Infectious Disease: An Official Journal of the Transplantation Society
Ana Cristina Carvalho da Costa, Jéssica Marques Ribeiro, Christiane Inocêncio Vasques, Graziela De Luca Canto, André Luís Porporatti, Paula Elaine Diniz Dos Reis
PURPOSE: The aim of this systematic review was to identify the interventions used to treat obstructive events, whether thrombotic or non-thrombotic, in long-term central venous catheters (LT-CVC) in cancer patients. METHODS: This review included clinical trials and observational studies reporting the drugs used to treat obstructive catheter events in cancer patients. The authors developed specific search strategies for CINAHL, Cochrane CENTRAL, LILACS, PubMed, Scopus, Web of Science, Google Scholar, Open Grey, and ProQuest...
October 29, 2018: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
Sushant Govindan, Ashley Snyder, Scott A Flanders, Vineet Chopra
OBJECTIVES: To quantify variation in use and complications from peripherally inserted central catheters placed in the ICU versus peripherally inserted central catheters placed on the general ward. DESIGN: Retrospective cohort study. SETTING: Fifty-two hospital Michigan quality collaborative. PATIENTS: Twenty-seven-thousand two-hundred eighty-nine patients with peripherally inserted central catheters placed during hospitalization...
December 2018: Critical Care Medicine
N LeVasseur, C Stober, K Daigle, A Robinson, S McDiarmid, S Mazzarello, B Hutton, A Joy, D Fergusson, J Hilton, M McInnes, M Clemons
Background: Despite advances in systemic therapy choices for patients with early-stage breast cancer, optimal practices for intravenous (IV) access remain unknown. That lack of knowledge holds particularly true for the use of central venous access devices (cvads) such as peripherally inserted central catheters (piccs) and implanted vascular access devices (ports). Methods: Using a survey of Canadian oncologists and oncology nurses responsible for the care of breast cancer patients, we evaluated current access practices, perceptions of complications, and perceptions of risk, and we estimated complication rates and evaluated perceived risk factors for lymphedema...
August 2018: Current Oncology
Asem Mansour, Salwa S Saadeh, Nayef Abdel-Razeq, Omar Khozouz, Mahmoud Abunasser, Ayat Taqash
Patients with cancer have an increased risk of venous thromboembolism. Upper extremity venous system is a peculiar site, and little is known about the clinical course in patients with cancer. Electronic medical records were searched for patients with cancer with a diagnosis of upper extremity venous thrombosis. Individual patient data were reviewed. Eighty-seven patients were identified, and the median age was 52.4. The most common underlying malignancies were breast (23.0%), colorectal (18.4%), and gastroesophageal (18...
November 2018: Clinical and Applied Thrombosis/hemostasis
Rafael Fernandes Bel Homo, Antônio Fernandes Costa Lima
OBJECTIVE: to identify the average direct cost of maintaining the patency of totally implanted central venous catheter with heparin at a Day Hospital of a public hospital of high complexity specialized in the treatment of cancer patients, and estimate the average direct cost of replacing heparin with sodium chloride 0.9%. METHOD: quantitative, exploratory-descriptive study, with a sample of 200 non-participant observations of the maintenance of totally implanted central venous catheters with heparin...
July 16, 2018: Revista Latino-americana de Enfermagem
Hervé Decousus, Aurélie Bourmaud, Pierre Fournel, Laurent Bertoletti, Carine Labruyère, Emilie Presles, Adel Merah, Silvy Laporte, Laetitia Stefani, Francesco Del Piano, Jean-Philippe Jacquin, Guy Meyer, Franck Chauvin
The need to accurately identify cancer outpatients at high risk of thrombotic complications is still unmet. In a prospective, multicenter cohort study (ONCOlogie et Chambres ImPlantables [ONCOCIP]), consecutive adult patients with a solid tumor and implanted port underwent 12-month follow-up. Our primary objective was to identify risk factors for (1) catheter-related thrombosis, defined as ipsilateral symptomatic upper-limb deep-vein thrombosis with or without pulmonary embolism, and (2) venous thromboembolism other than catheter-related, defined as any symptomatic superficial- or deep-vein thrombosis (other than catheter-related) or pulmonary embolism, and incidental pulmonary embolism...
August 16, 2018: Blood
Sun Hong, Tae-Seok Seo, Myung Gyu Song, Hae-Young Seol, Sang Il Suh, In-Seon Ryoo
PURPOSE: To evaluate the clinical outcomes and complications of totally implantable venous access port implantation via the axillary vein in patients with head and neck malignancy. MATERIALS AND METHODS: A total of 176 totally implantable venous access ports were placed via the axillary vein in 171 patients with head and neck malignancy between May 2012 and June 2015. The patients included 133 men and 38 women, and the mean age was 58.8 years (range: 19-84 years)...
June 1, 2018: Journal of Vascular Access
Yajuan Lv, Yong Hou, Bo Pan, Yuwan Ma, Paiyun Li, Lili Yu, Deguo Xu, Juanjuan Song, Heli Shang, Hongyan Wang, Yuan Tian
The risk of venous thrombosis and mortality associated with central catheter (PICC/CICC) for malignant tumor patients is not definite. So, we carried out a systematic review and meta-analysis to evaluate it. Among patients with comparing PICC with CICC, odds ratio (OR) or risk ratio (RR) was calculated with a random effect model meta-analysis. The result of the stratification analysis of 7 studies (PICC vs CICC) supported the theory that CICCs were associated with a decrease in the odds ratio of thrombosis compared with PICCs...
February 23, 2018: Oncotarget
Fulvio Pinelli, Elena Cecero, Dario Degl'Innocenti, Valentina Selmi, Rosa Giua, Gianluca Villa, Cosimo Chelazzi, Stefano Romagnoli, Mauro Pittiruti
Totally implantable venous access devices, or ports, are essential in the therapeutic management of patients who require long-term intermittent intravenous therapy. Totally implantable venous access devices guarantee safe infusion of chemotherapy, blood transfusion, parenteral nutrition, as well as repeated blood samples. Minimizing the need for frequent vascular access, totally implantable venous access devices also improve the patient's quality of life. Nonetheless, totally implantable venous access devices are not free from complications...
May 2018: Journal of Vascular Access
Brent Burbridge, Chris Plewes, Grant Stoneham, Peter Szkup, Rob Otani, Paul Babyn, Rhonda Bryce
PURPOSE: To evaluate the hypothesis that power-injectable (PI) totally implanted venous access devices (TIVADs) situated in the arm are associated with more frequent complications and complication-related removal than non-power-injectable (NPI) arm TIVADs among adult cancer patients. MATERIALS AND METHODS: In this single-center trial, 211 adult chemotherapy patients were randomized to receive either a PI or a NPI arm TIVAD. Follow-up involved a standardized telephone interview 1 week after insertion, followed by a chest X-ray, arm X-ray, and Doppler ultrasound at 3 months and 12 months...
May 2018: Journal of Vascular and Interventional Radiology: JVIR
Adrian Vk Wong, Nitin Arora, Olusegun Olusanya, Ben Sharif, Robert M Lundin, A Dhadda, S Clarke, R Siviter, M Argent, Gavin Denton, Anna Dennis, Angela Day, Tamas Szakmany
Background: Central venous catheters are inserted ubiquitously in critical care and have roles in drug administration, fluid management and renal replacement therapy. They are also associated with numerous complications. The true number of central venous catheters inserted per year and the proportion of them associated with complications are unknown in the UK. Methods: We performed a prospective audit at five hospitals, as a feasibility pilot for a larger, nationwide audit...
February 2018: Journal of the Intensive Care Society
Merilda O Blanco-Guzman
Implantable vascular access devices are frequently used in patients who have poor peripheral venous access. These devices can be partially implanted as tunneled and nontunneled central catheters, or they can be fully implanted as ports. Compared with long-term catheters, implanted ports have lower infection rates and improved perceptions of quality of life, but complications still occur in 2% to 18% of patients, frequently requiring removal of the device. Since the conception of implantable vascular access device ports, numerous advances in port design, materials, and techniques for implantation and care have been developed with the goal of overcoming frequent complications...
February 2018: Transfusion
H Bouzidi, A Emirian, A Marty, E Chachaty, A Laplanche, B Gachot, F Blot
OBJECTIVES: Differential time to positivity of cultures of blood drawn simultaneously from central venous catheter and peripheral sites is widely used to diagnose catheter-related bloodstream infections without removing the catheter. However, the accuracy of this technique for some pathogens, such as Staphylococcus aureus, is debated in routine practice. METHODS: In a 320-bed reference cancer centre, the charts of patients with at least one blood culture positive for S...
June 2018: Journal of Hospital Infection
Vineet Chopra, Scott Kaatz, Paul Grant, Lakshmi Swaminathan, Tanya Boldenow, Anna Conlon, Steven J Bernstein, Scott A Flanders
BACKGROUND: Catheter exchange over a guidewire is frequently performed for malfunctioning peripherally inserted central catheters (PICCs). Whether such exchanges are associated with venous thromboembolism is not known. METHODS: We performed a retrospective cohort study to assess the association between PICC exchange and risk of thromboembolism. Adult hospitalized patients that received a PICC during clinical care at one of 51 hospitals participating in the Michigan Hospital Medicine Safety consortium were included...
June 2018: American Journal of Medicine
David Paje, Anna Conlon, Scott Kaatz, Lakshmi Swaminathan, Tanya Boldenow, Steven J Bernstein, Scott A Flanders, Vineet Chopra
BACKGROUND: The guidelines for peripherally inserted central catheters (PICCs) recommend avoiding insertion if the anticipated duration of use is =5 days. However, short-term PICC use is common in hospitals. We sought to identify patient, provider, and device characteristics and the clinical outcomes associated with short-term PICCs. METHODS: Between January 2014 and June 2016, trained abstractors at 52 Michigan Hospital Medicine Safety (HMS) Consortium sites collected data from medical records of adults that received PICCs during hospitalization...
February 2018: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
Mario Matiotti-Neto, Mariam F Eskander, Omidreza Tabatabaie, Gyulnara Kasumova, Lindsay A Bliss, Sing Chau Ng, Nicholas E Tawa, Blanche Murphy, Jonathan F Critchlow, Jennifer F Tseng
The superiority of surgical cut-down of the cephalic vein versus percutaneous catheterization of the subclavian vein for the insertion of totally implantable venous access devices (TIVADs) is debated. To compare the safety and efficacy of surgical cut-down versus percutaneous placement of TIVADs. This is a single-institution retrospective cohort study of oncologic patients who had TIVADs implanted by 14 surgeons. Primary outcomes were inability to place TIVAD by the primary approach and postoperative complications within 30 days...
December 1, 2017: American Surgeon
Huashe Wang, Yonghe Chen, Aihong Liu, Jun Xiang, Yijia Lin, Yue'e Wen, Xiaobin Wu, Junsheng Peng
OBJECTIVE: To describe and analyze the complications of subcutaneous venous access port for patients with gastrointestinal malignancy. METHODS: Data of 1 912 patients with gastrointestinal malignancy who accepted chemotherapy in our department via subcutaneous venous access ports, including 127 cases in upper arm, 865 cases in subclavicular vein and 920 cases in internal jugular vein, from June 2007 to April 2016 were analyzed retrospectively. Associated complications and risk factors were emphatically investigated...
December 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
Zhaoxin Dong, Bairbre L Connolly, Wendy J Ungar, Peter C Coyte
PURPOSE: A peripherally inserted central catheter (PICC) is a useful option in providing secure venous access, which enables patients to be discharged earlier with the provision of home care. The objective was to identify the costs associated with having a PICC from a societal perspective, and to identify factors that are associated with total PICC costs. METHODS: Data were obtained from a retrospective cohort of 469 hospitalized pediatric patients with PICCs inserted...
January 2018: International Journal of Technology Assessment in Health Care
2017-12-22 08:21:42
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