Vascular access devices used during harvest of peripheral blood stem cells: high complication rate in patients with a long-term dialysis central venous catheter

Abstract Background: Long term venous catheters have been used to deliver specialized therapies since 1968. The ideal tip position of a central venous catheter provides reliable venous access with optimal therapeutic delivery, while minimizing short-and long-term complications. Ideal position limits have evolved and narrowed over time, making successful placement difficult and unreliable when depending exclusively on the landmark technique. Objective: To review and analyze contemporary literature and calculate an overall accuracy rate for first attempt placement of a PICC catheter in the ideal tip position. Methods: Key PICC placement terms were used to search the database PubMED-indexed for MEDLINE in June and October, 2009. The selection of studies required: a patient cohort without tip placement guidance technology; a documented landmark technique to place catheter tips; data documenting initial catheter placement and, that the lower third of the SVC and the cavo-atrial junction (CAJ) were included in the placement criteria. With few exceptions, articles written between 1993 and 2009 met the stated selection criteria. A composite of outcomes associated with tip placement was analyzed, and an overall percent proficiency of accurate catheter tip placement calculated. Results: Nine studies in eight articles met the selection criteria and were included for analysis. Rates of first placement success per study ranged from 39% to 75%, with the majority (7/9) being single center studies. The combined overall proficiency of these studies calculated as a weighted average was 45.87%.

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Relapsing pyrogenic reactions due to Xanthomonas maltophilia in a dialysis patient with a long-term central venous catheter

Nephrology Dialysis Transplantation ◽

10.1093/oxfordjournals.ndt.a027043 ◽

1996 ◽

Vol 11 (1) ◽

pp. 197-198 ◽

Cited By ~ 6

Author(s):

M. Ganadu ◽

G. L. Mura ◽

A. M. Campus ◽

G. L. Cherchi ◽

V. Fanelli ◽

...

Keyword(s):

Central Venous Catheter ◽

Dialysis Patient ◽

Venous Catheter ◽

Central Venous ◽

Xanthomonas Maltophilia

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Interventions to obstructive long-term central venous catheter in cancer patients: a meta-analysis

Supportive Care in Cancer ◽

10.1007/s00520-018-4500-y ◽

2018 ◽

Vol 27 (2) ◽

pp. 407-421 ◽

Cited By ~ 2

Author(s):

Ana Cristina Carvalho da Costa ◽

Jéssica Marques Ribeiro ◽

Christiane Inocêncio Vasques ◽

Graziela De Luca Canto ◽

André Luís Porporatti ◽

...

Keyword(s):

Central Venous Catheter ◽

Cancer Patients ◽

Meta Analysis ◽

Venous Catheter ◽

Central Venous

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Long-Term Central Venous Catheter Infection in HIV-infected and Cancer Patients: A Multicenter Cohort Study

Infection Control and Hospital Epidemiology ◽

10.1086/501658 ◽

1999 ◽

Vol 20 (7) ◽

pp. 494-498 ◽

Cited By ~ 25

Author(s):

Pascal Astagneau ◽

Sylvie Maugat ◽

Tuan Tran-Minh ◽

Marie-Cécile Douard ◽

Pascale Longuet ◽

...

Keyword(s):

Cohort Study ◽

Central Venous Catheter ◽

Cancer Patients ◽

Venous Catheter ◽

Central Venous ◽

Hiv Patients ◽

Multicenter Cohort Study ◽

Multicenter Cohort ◽

Hiv And Cancer

Objectives:To evaluate and compare the risk of long-term central venous catheter (CVC) infection in human immunodeficiency virus (HIV)-infected and cancer patients.Design:Prospective multicenter cohort study based on active surveillance of long-term CVC manipulations and patient outcome over a 6-month period.Setting:Services of infectious diseases and oncology of 12 university hospitals in Paris, France.Participants:In 1995, all HIV and cancer patients with solid malignancy were included at the time of long-term CVC implantation.Results:Overall, 31.6% of long-term CVC infections were identified in 32% of 201 HIV and 5% of 255 cancer patients. Most were associated with bacteremia, most commonly coagulase-negative staphylococci. The long-term CVC time-related infection risk was greater in HIV than in cancer patients (3.78 vs 0.39 infections per 1,000 long-term CVC days; P<.001). The independent risk factors of long-term CVC infection were as follows: in HIV patients, frequency of long-term CVC handling and neutropenia; in cancer patients, poor Karnofsky performance status; in both HIV and cancer patients, recent history of bacterial infection. The risk of long-term CVC infection was similar for tunneled catheters and venous access ports in each population.Conclusions:Prevention of long-term CVC infection should focus first on better sterile precautions while handling long-term CVC, especially in HIV patients who have frequent and daily use of the long-term CVC.

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A central venous catheter for long-term studies on drug effects and pharmacokinetics in Munich minipigs

European Journal of Drug Metabolism and Pharmacokinetics ◽

10.1007/bf03191316 ◽

1988 ◽

Vol 13 (2) ◽

pp. 143-147 ◽

Cited By ~ 2

Author(s):

W. Schmidt ◽

A. Dehn ◽

J. F. Hutter

Keyword(s):

Central Venous Catheter ◽

Drug Effects ◽

Venous Catheter ◽

Central Venous ◽

Long Term Studies

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Long-term response of juvenile idiopathic arthritis after conditioning with 8 Gy total body irradiation followed by autologous peripheral blood stem cells: Case report

Pediatric Transplantation ◽

10.1111/j.1399-3046.2009.01129.x ◽

2010 ◽

Vol 14 (6) ◽

pp. E65-E69 ◽

Cited By ~ 1

Author(s):

Ann Woolfrey ◽

Jan Storek ◽

Suzanne Bowyer ◽

Robert Nelson ◽

Michael Robertson ◽

...

Keyword(s):

Stem Cells ◽

Juvenile Idiopathic Arthritis ◽

Case Report ◽

Total Body Irradiation ◽

Peripheral Blood ◽

Peripheral Blood Stem Cells ◽

Blood Stem Cells ◽

Total Body ◽

Term Response

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Anatomic Site-Specific Complication Rates for Central Venous Catheter Insertions

Journal of Intensive Care Medicine ◽

10.1177/0885066618795126 ◽

2018 ◽

Vol 35 (9) ◽

pp. 869-874 ◽

Cited By ~ 4

Author(s):

Jacob Bell ◽

Munish Goyal ◽

Sallie Long ◽

Anagha Kumar ◽

Joseph Friedrich ◽

...

Keyword(s):

Central Venous Catheter ◽

Complication Rate ◽

Venous Catheter ◽

Complication Rates ◽

Central Venous ◽

Site Specific ◽

Mechanical Complications ◽

Significant Difference ◽

Insertion Techniques ◽

Delayed Complications

Background: Central venous catheter (CVC) complication rates reflecting the application of modern insertion techniques to a clinically heterogeneous patient populations are needed to better understand procedural risk attributable to the 3 common anatomic insertion sites: internal jugular, subclavian, and femoral veins. We sought to define site-specific mechanical and duration-associated CVC complication rates across all hospital inpatients. Methods: A retrospective chart review was conducted over 9 months at Georgetown University Hospital and Washington Hospital Center. Peripherally inserted central catheters and tunneled or fluoroscopically placed CVC’s were excluded. Mechanical complications (retained guidewire, arterial injury, and pneumothorax) and duration-associated complications (deep vein thrombosis or pulmonary embolism, and central line-associated bloodstream infections) were identified. Results: In all, 1179 CVC insertions in 801 adult patients were analyzed. Approximately 32% of patients had multiple lines placed. Of 1179 CVCs, 73 total complications were recorded, giving a total rate of one or more complications occurring per CVC of 5.9%. There was no statistically significant difference between site-specific complications. A total of 19 mechanical complications were documented, with a 1.5% complication rate of one or more mechanical complications occurring. A total of 54 delayed complications were documented, with a 4.4% complication rate of 1 or more delayed complications occurring. There were no statistically significant differences between anatomic sites for either total mechanical or total delayed complications. Conclusions: These results suggest that site-specific CVC complication rates may be less common than previously reported. These data further inform on the safety of modern CVC insertion techniques across all patient populations and clinical settings.

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