Relapsing pyrogenic reactions due to Xanthomonas maltophilia in a dialysis patient with a long-term 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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Vascular access devices used during harvest of peripheral blood stem cells: high complication rate in patients with a long-term dialysis central venous catheter

Bone Marrow Transplantation ◽

10.1038/sj.bmt.1701988 ◽

1999 ◽

Vol 24 (7) ◽

pp. 793-797 ◽

Cited By ~ 13

Author(s):

E Johansson ◽

M Hansson ◽

A Sollén Nilsson ◽

P Engervall

Keyword(s):

Stem Cells ◽

Central Venous Catheter ◽

Complication Rate ◽

Venous Catheter ◽

High Complication Rate ◽

Central Venous ◽

Peripheral Blood Stem Cells ◽

Vascular Access Devices ◽

Blood Stem Cells

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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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Bundle Approach to Reduce Bloodstream Infections in Neutropenic Hematologic

Acta Médica Portuguesa ◽

10.20344/amp.6002 ◽

2015 ◽

Vol 28 (4) ◽

pp. 474

Author(s):

Jose Manuel Martinez ◽

Luís Leite ◽

Daniela França ◽

Rita Capela ◽

Luísa Viterbo ◽

...

Keyword(s):

Relative Risk ◽

Central Venous Catheter ◽

Bloodstream Infections ◽

Mechanical Valve ◽

Venous Catheter ◽

Positive Pressure ◽

Control Group ◽

Study Group ◽

Central Venous

Introduction: The objective of the study was to reduce, by a bundle of interventions, the global bloodstream infections and catheterrelated bloodstream infections rates in neutropenic hematology patients with a long-term central venous catheter. Material and Methods: This was a non-randomized prospective study. It was conducted in a 20-bed hematology oncology unit (Portuguese Institute of Oncology, Porto, Portugal) between 1st of August 2010 and 31st of January 2012. In this period we introduced a bundle of interventions (study group) and compared the results with the six months prior to implementation (control group). The interventions consisted in the use of a neutral pressure mechanical valve connector instead of a positive pressure mechanical valve connector, a more frequent change of this connector and a more efficient clean solution. One hundred and sixteen hematology patients with a long-term central venous catheter at time superior of 72 h, with 8 867 central venous catheter days [6 756 central venous catheter days in the study group and 2 111 central venous catheter days in the control group] were included in the study. Results: A significant reduction in bloodstream infections rates and catheter-related bloodstream infections rates was achieved. Bloodstream infections rates: [32.69 (control group) vs. 9.43 (study group)], incidence reduction 71% [relative risk 0.2886, CI 95% (0.1793 – 0.4647), p < 0.001] and catheter-related bloodstream infections rates: [17.53 (control group) vs. 4.73 (study group)], incidence reduction 71% [relative risk 0.2936, CI 95% (0.1793 – 0.5615), p < 0.014]. No significant difference (p > 0.05) was found in the neutrophil count at the time of blood culture samples between groups: 69% (< 500 neutrophils/mm3) [71% (study group) vs. 68% (control group)]. Conclusions: The introduction of this bundle of interventions based on the variables of patient, product and practice, supported by the Healthcare and Technology Synergy framework, quickly resulted in a significant reduction of bloodstream infections and catheterrelated bloodstream infections rates.

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