Oxaliplatin infusion-related venous pain: prevention by simultaneous intravenous fluids

2020 ◽  
pp. bmjspcare-2019-002177
Author(s):  
Stefan van Ravensteijn ◽  
Britt van Merrienboer ◽  
Stefan van Asten ◽  
Johannes Pruijt ◽  
Mirrian Hilbink ◽  
...  
Keyword(s):  
Central Venous Catheter ◽  
Cancer Patients ◽  
Gastrointestinal Cancer ◽  
Primary Outcome ◽  
Venous Catheter ◽  
Primary Outcome Measure ◽  
Central Venous ◽  
Fluid Infusion ◽  
Number Of Patients ◽  
Vascular Pain

ObjectiveOxaliplatin is a cytotoxic agent frequently used in the treatment of gastrointestinal cancer patients. A known side effect of oxaliplatin administration via a peripheral vein is infusion-related pain. In this retrospective cohort study we compared the incidence of infusion-related pain in patients treated with oxaliplatin with or without simultaneous fluid infusion (FI) (800 mL glucose 5% in 2 hours).MethodsWe retrospectively defined two cohorts: Patients treated with oxaliplatin and simultaneous intravenous FI and the same number of patients treated without FI.The incidence of infusion-related venous pain was the primary outcome measure. Secondary outcomes included: Incidence of hypersensitivity reactions, infusion time, dose density, number of patients switched to a central venous catheter and incidence of peripheral neuropathy.Results100 patients were included, 50 patients in both groups. Baseline characteristics were comparable, except for age (median 66.8 vs 62.4 years in groups with and without FI; p=0.017), and body mass index (28.0 vs 25.7 kg/m2, respectively; p=0.012). Patients treated with simultaneous FI experienced significantly less vascular pain compared with those without FI (10% vs 78%, respectively; p<0.0001; OR 0.031 (95% CI: 0.01 to 0.098)). No difference was observed in dose density, treatment delay or the need of central venous catheter. Logistic regression analysis showed no confounders affecting the primary outcome. No adverse events of FI were observed.ConclusionConcurrent infusion of 800 mL glucose 5% with peripheral venous administration of oxaliplatin significantly reduces the incidence of infusion-related pain in gastrointestinal cancer patients and is highly feasible and affordable in everyday clinical practice.

Inefficiency in 6-Set Requests for Blood Culture Analysis of Cancer Patients with the Central Venous Catheter

2013 ◽  
Vol 3 (3) ◽  
pp. 155
Author(s):  
Dong-Hyun Lee ◽  
Eun-ha Koh ◽  
Sunjoo Kim ◽  
In-Gyu Bae ◽  
Hoon-gu Kim ◽  
...  
Keyword(s):  
Blood Culture ◽  
Central Venous Catheter ◽  
Cancer Patients ◽  
Venous Catheter ◽  
Central Venous

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

2018 ◽  
Vol 27 (2) ◽  
pp. 407-421 ◽  
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

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

1999 ◽  
Vol 20 (7) ◽  
pp. 494-498 ◽  
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.

Central venous catheter andStenotrophomonas maltophilia bacteremia in cancer patients

Cancer ◽  
2006 ◽  
Vol 106 (9) ◽  
pp. 1967-1973 ◽  
Author(s):  
Maha Boktour ◽  
Hend Hanna ◽  
Shoaib Ansari ◽  
Boulos Bahna ◽  
Ray Hachem ◽  
...  
Keyword(s):  
Central Venous Catheter ◽  
Cancer Patients ◽  
Venous Catheter ◽  
Central Venous

scholarly journals Impact of Catheter Management on Clinical Outcome in Adult Cancer Patients With Gram-Negative Bacteremia

2019 ◽  
Vol 6 (10) ◽  
Author(s):  
Johny Fares ◽  
Melissa Khalil ◽  
Anne-Marie Chaftari ◽  
Ray Hachem ◽  
Ying Jiang ◽  
...  
Keyword(s):  
Central Venous Catheter ◽  
Cancer Patients ◽  
Bloodstream Infection ◽  
Bloodstream Infections ◽  
Venous Catheter ◽  
Mucosal Barrier ◽  
Central Venous ◽  
Gram Negative ◽  
Central Venous Catheter Removal ◽  
Mucosal Barrier Injury

Abstract Objective Gram-negative organisms have become a major etiology of bloodstream infections. We evaluated the effect of central venous catheter management on cancer patients with gram-negative bloodstream infections. Method We retrospectively identified patients older than 14 years with central venous catheters who were diagnosed with gram-negative bloodstream infections to determine the effect of catheter management on outcome. Patients were divided into 3 groups: Group 1 included patients with central line-associated bloodstream infections (CLABSI) without mucosal barrier injury and those whose infection met the criteria for catheter-related bloodstream infection; group 2 included patients with CLABSI with mucosal barrier injury who did not meet the criteria for catheter-related bloodstream infection; and group 3 included patients with non-CLABSI. Results The study included 300 patients, with 100 patients in each group. Only in group 1 was central venous catheter removal within 2 days of bloodstream infection significantly associated with a higher rate of microbiologic resolution at 4 days compared to delayed central venous catheter removal (3–5 days) or retention (98% vs 82%, P = .006) and a lower overall mortality rate at 3-month follow-up (3% vs 19%, P = .01). Both associations persisted in multivariate analyses (P = .018 and P = .016, respectively). Conclusions Central venous catheter removal within 2 days of the onset of gram-negative bloodstream infections significantly improved the infectious outcome and overall mortality of adult cancer patients with catheter-related bloodstream infections and CLABSI without mucosal barrier injury.

A Pilot Study of Central Venous Catheter Survival in Cancer Patients Using Low Molecular Weight Heparin (Dalteparin) for the Treatment of Deep Vein Thrombois of the Upper Extremity (UEDVT).

Blood ◽  
2006 ◽  
Vol 108 (11) ◽  
pp. 878-878
Author(s):  
Michael J. Kovacs ◽  
Roseann Andreou ◽  
Marc Rodger ◽  
David R. Anderson ◽  
Susan R. Kahn ◽  
...  
Keyword(s):  
Venous Thromboembolism ◽  
Central Venous Catheter ◽  
Thrombolytic Therapy ◽  
Cancer Patients ◽  
Venous Catheter ◽  
Central Line ◽  
Central Venous ◽  
Major Hemorrhage ◽  
Recurrent Venous Thromboembolism

Abstract Background: Central venous catheters (e.g., PICC lines and Hickman-type catheters) in patients with cancer are associated with development of DVT in 1–3%. Patient management varies from immediate removal of the line, with or without anticoagulation, to the extreme of thrombolytic therapy. This multicenter cohort clinical trial was designed to assess the safety and effectiveness of a management strategy for central venous catheter-related UEDVT in cancer patients consisting of dalteparin and warfarin as a means of salvaging the line without the need for line removal. Methods: Patients greater than 18 years-of-age with an active malignancy and who had symptomatic, acute, objectively documented UEDVT were eligible. Patients were excluded if the catheter was a dialysis catheter, they had active bleeding or a high risk for major bleeding, platelet count &lt;100 ×09/L, serum creatinine &gt;177μmol/l, if they were currently on therapeutic doses of warfarin, inability to infuse through the catheter after a trial of intraluminal thrombolytic therapy (2mg TPA), had AML or ALL or bone marrow/stem cell transplant planned in the next 3 months or if they did not provided written informed consent. Four centers in Canada participated. Patients were treated with dalteparin 200 IU/kg per day for 5–7 days and simultaneously initiated on warfarin with a target INR of 2.0–3.0. Patients were followed for 3 months for recurrent venous thromboembolism, major hemorrhage and survival of the central venous catheter. Results: There were 74 patients (48 males) enrolled from November 2002 to December 2005. The average age was 58 years. Seventy-one UEDVTs were diagnosed by ultrasound and three by CT. There were 57 PICC lines, 14 portacaths and 3 Hickman catheters. Sixty-four patients (86%) completed three-month follow-up. Of the 10 who did not, 7 died (6 due to cancer and 1 due to a major bleed) and 3 others were no longer evaluable (2 patients were treated with LMWH only and another patient had the line removed against protocol). There were no episodes of recurrent venous thromboembolism and 3 (4%) major bleeds. For the endpoint of line survival, 42 (57%) of the lines were in situ and still functional at three months. No lines were removed due to infusion failure or recurrence/extension of DVT. In the 32 patients who had line removal before the study three-month endpoint, 21 were due to the end of therapeutic need, 2 were due to infection and 9 for other reasons such as falling out, skin irritation, patient request, etc. Hence, 63 (85%) patients were able to maintain the central line until it was no longer needed, or for at least three months. For the 11 others, none were removed due to venous thrombosis or line failure. Conclusion: Treatment of UEDVTs secondary to central catheters in cancer patients with standard dalteparin/warfarin can allow the central line to remain in situ with little risk of line failure or recurrence/extension of the DVT.

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