Venous access in cancer patients
Authors:
O. Zapletal 1; L. Sirotek 1; O. Coufal 1,2,3
Authors‘ workplace:
Klinika operační onkologie, Masarykův onkologický ústav, Brno
1; Klinika operační onkologie, Lékařská fakulta Masarykovy univerzity, Brno
2; Regionální centrum aplikované molekulární onkologie (RECAMO), Brno
3
Published in:
Rozhl. Chir., 2019, roč. 98, č. 11, s. 427-433.
Category:
Review
doi:
https://doi.org/10.33699/PIS.2019.98.11.427–433
Overview
The most commonly used permanent venous access devices in cancer patients are the port, PICC port and PICC catheter (peripherally inserted central catheter). It is always necessary to consider the type of venous access needed for each individual cancer patient. Implantation should be performed using modern instruments to minimize the risk of early and late complications and thereby a delay in oncological treatment. The use of ultrasound is recommended at all stages of introduction. Precise tip placement of the central catheter in the sinoatrial junction region further reduces the number of thromboses arising in the catheter. A trend towards the treatment of catheter infections is certainly to maintain the venous access without compromising the patient’s health. Permanent venous access devices allow the application of chemotherapy and repeated blood sample collections with minimal impact on the quality of life in cancer patients.
Keywords:
port – PICC – cancer patient – complication – tip position
Sources
- http://www.sppk.eu/?page_id=488
- Maňásek V. Extravazace cytostatik – prevence a doporučené postupy. Klin Onkol. 2016;29:93−9.
- Denys GB, Uretsky BF, Reddy PS. Ultrasound-assisted cannulation of the internal jugular vein: a prospective comparison to the external landmark-guided technique. Circulation 1993;1557–62. doi. 10.1161/01.cir.87.5.1557.
- Sommerkamp SK, Romaniuk VM, Witting MD, et al. A comparison of longitudinal and transverse approaches to ultrasound-guided axillary vein cannulation. Am J Emerg Med. 2013;31:478−81. doi: 10.1016/j.ajem.2012.09.015.
- Skolnick ML. The role of sonography in the placement and management of jugular and subclavian central venous catheters. AJR Am J Roentgenol. 1994;291–5. doi: 10.2214/ajr.163.2.8037017.
- Patel GS, Jain R, Kumar R, et al. Comparison of peripherally inserted central venous catheters (PICC) versus subcutaneosly implanted port-chamber catheters by complication and cost for patients receiving chemotherapy for non-haematological malignancies. Support Care Cancer 2014;22:121−8. doi: 10.1007/s00520-013-1941-1.
- Mermel LA, Allon M, Bouza E, et al. Clinical practice guidelines for the diagnosis and management of intravascular catheter-related infection: 2009 Update by the Infectious Diseases Society of America. Clin Infect Dis. 2009;49:1−45. doi: 10.1086/599376.
- Musuuza JS, Guru PK, O´Horo JC, et al. The impact of chlorhexidine bathing on hospital-acquired bloodstream infections: a systematic review and meta-analysis. BMC Infect Dis. 2019;19:416. doi: 10.1186/s12879-019-4002-7.
- Walser EM. Venous access ports: Indication, implantation technique, follow-up and complication. Cardiovasc Intervent Radiol. 2012;35:751−64. doi: 10.1016/j.jvir.2009.07.035.
- Biffi R, Orsi F, Pozzi S, et al. Best choice of central venous insertion site for the prevention of catheter-related complications in adult patients who need cancer therapy: a randomized trial. Ann Oncol. 2009;20:935−40. doi: 10.1093/annonc/mdn701.
- Petersen J, Delaney JH, BrakstadMT, et al. Silicone venous access devices positioned with their tips high in the superior vena cava are more likely to malfunction. Am J Surg. 1999;178:38−41. doi: 10.1016/s0002-9610(99)00124-5.
- Caers J, Fontaine C, Vinh-Hung V, et al. Catheter tip position as a risk factor for thrombosis associated with the use of subcutaneous infusion ports. Support care cancer 2005;13:325−31. doi: 10.1007/s00520-004-0723-1.
- Shan PN, Kane D, Appukutty J. Depth of central venous catheterization by intracardiac electrocardiogram in adults. Anestesiology and pain medicine 2013;2:111−4. doi: 10.5812/aapm.7557.
- Olivier G, et al. ECG-based PICC tip verification system: an evaluation 5 years on. Br J Nurs. 2016;25:S4−S10. doi: 10.12968/bjon.2016.25.19.S4.
- Pittiruti M, Bertollo D, Briglia E, et al. The intracavitary ECG method for positioning the tip of central venous catheters: results of an Italian multicenter study. J Vasc Access. 2012;13:357−65. doi: 10.5301/JVA.2012.9020.
- Gao Y, Liu Y, Zhang H, et al. The safety and accurancy of ECG-guided PICC tip position verification applied in patients with atrial fibrillation. Ther Clin Risk Manag. 2018;14:1075−81. doi: 10.2147/TCRM.S156468.
- Sharma D, Farabakhsh N, Tabatabaii SA. Role of ultrasound for central catheter tip localization in neonates: a review of the current evidence. J Matern Fetal Neonatal Med. 2019;32:2429−37. doi: 10.1080/14767058.2018.1437135.
- Contractor SG, Phatak TD, Klyde D, et al. Single-incision technique for tunneled central venous access. J Vasc Interv Radiol. 2009;20:1052−8. doi: 10.1016/j.jvir.2009.04.065.
- Hind D, Calvert N, McWilliams, et al. Ultrasonic locating devices for central venous cannulation: metaanalysis. BMJ 2003;327:361. doi: 10.1136/bmj.327.7411.361.
- Araújo C, Silva JP, Antunes P, et al. A comparative study between two central veins for the introduction of totally implantable venous access devices in 1201 cancer patients. Eur J Surg Oncol. 2008;34:222−6. doi: 10.1016/j.ejso.2007.04.003.
- Chang DH, Boecker J, Hellmich M, et al. Experiences with ultrasound-guided port implantations via the lateral subclavian vein: a retrospective analysis of 1532 patients. Rofo 2012;184:726−33. doi: 10.1055/s-0032-1312745.
- Mudan S, Giakoustidis D, Morrison D, et al. 1000 Port-A-Cath placements by subclavian vein approach: single surgeon experience. World J Surg. 2015;39:328−34. doi: 10.1007/s00268-014-2802-x.
- Popálená J. Katétrové infekcie u pacientov v programe domácej parenterálnej výživy. Nutrition news 2019;3:18−21.
- Blot K, Bergs J, Vogelaers D, et al. Prevention of central line-associated bloodstream infection through quality improvement interventions: a systematic review and meta-analysis. Clin Infect Dis. 2014;59:96−105. doi: 10.1093/cid/ciu239.
- Verso M, Agnelli G, Bertoglio S, et al. Enoxaparin for the prevention of venous thromboembolism associated with central vein catheter: a double-blind, placebo-controlled, randomized study in cancer patients. J Clin Oncol. 2005:4057–62. doi: 10.1200/JCO.2005.06.084.
- Reddy AS, Lang EV, Cutts J, et al. Fibrin sheath removal from central venous catheters: an internal snare manoeuvre. Nephrol Dial Transplant. 2007;22:1762–5. doi: 10.1093/ndt/gfm154.
- Namyslowski J, et al. Management of catheter-induced venous thrombosis. Tech Vasc Interv Radiol. 2002;5:85−8. Review. doi: 10.1053/tvir.2002.36052.
- Taxbro K, Hammarskjöld F, Thelin B, et al. Clinical impact of peripherally inserted central catheters vs implanted port catheters in patients with cancer: an open-label, randomised, two-center trial. British Journal od Anaesthesia 2019;122:734−1. doi: 10.1016/j.bja.2019.01.038.
- Busch JD, Vens M, Herrmann J, et al. Material failure of silicone catheter lines: A retrospective review of partial and complete ruptures in 553 patients. AJR Am Roentgenol. 2017;208:464−9. doi: 10.2214/AJR.16.16540.
- Song MG, Seo TS, Kim YH, et al. Effectiveness of breast fixation to reduce migration of the tip of a totally implantable venous access port in women. J Vasc Access. 2016;17:348−52. doi: 10.5301/jva.5000565.
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Surgery Orthopaedics Trauma surgeryArticle was published in
Perspectives in Surgery
2019 Issue 11
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