CENTRAL VEIN CATHETERIZATION IN ONCOHEMATOLOGICAL PRACTICE: RISK OF COMPLICATIONS
Author(s): ,
Nikolay Romanenko
Affiliations:
Clinical Hematology,Russian Research Institute of Hematology and Transfusiology, FMBA of Russia,Saint-Petersburg,Russian Federation
,
Alexandr Schmidt
Affiliations:
Clinical Hematology,Russian Research Institute of Hematology and Transfusiology, FMBA of Russia,Saint-Petersburg,Russian Federation
,
Tatyana Glazanova
Affiliations:
Immuanology,Russian Research Institute of Hematology and Transfusiology, FMBA of Russia,Saint-Petersburg,Russian Federation
,
Elena Shilova
Affiliations:
Clinical Hematology,Russian Research Institute of Hematology and Transfusiology, FMBA of Russia,Saint-Petersburg,Russian Federation
,
Vitaliy Chebotkevich
Affiliations:
Bacteriology,Russian Research Institute of Hematology and Transfusiology, FMBA of Russia,Saint-Petersburg,Russian Federation
Sergey Voloshin
Affiliations:
Clinical Hematology,Russian Research Institute of Hematology and Transfusiology, FMBA of Russia,Saint-Petersburg,Russian Federation
EHA Library. Romanenko N. Jun 15, 2019; 267207; PS1590
Mr. Nikolay Romanenko
Mr. Nikolay Romanenko
Contributions
Abstract

Abstract: PS1590

Type: Poster Presentation

Presentation during EHA24: On Saturday, June 15, 2019 from 17:30 - 19:00

Location: Poster area

Background
The insertion of the central venous catheter (CVC) is a vascular access method used in resuscitation and oncohematology and it is required during intensive infusion and chemotherapy. However, due to the invasiveness of the procedure, complications are possible due to the procedure and course of the underlying disease.

Aims
Assess the frequency of complications related to central vein catheterization in patients with hematology malignancies (HM).

Methods
We have analyzed 2506 cases of CVC performed to patients with HM for the period from 2003 to 2018. All patients underwent catheterization of the right (82%), left (17.6%) subclavian vein or v. Jugularis externa (0.4%). Bacteriology tests were performed if a catheter-related infection was suspected (n=353).

Results
Out of 2506 catheterizations bloodstream infections in the form of sepsis or bacteremia were documented in 2.5% of patients (n=63), phlebitis, thrombophlebitis and infiltrate at CVC area were revealed in 2.6% (n=66), lymphorrhea – in 1.3% (n=33), catheter bleeding – in 3.9% (n=73), haematoma – in 4.3% (n=109), artery puncture (a. Subclavia dextra or sinistra) – in 3.0% (n=76), pain, numbness, paresthesia of the upper limb – in 1.6% (n=41), weakness, collapse – in 1.1% (n=27), pneumothorax – in 0.2% of patients(n=4). Positive bacterial cultures from venous blood were detected in 63 patients, with mixed infection in 8 cases  (2 or 3 microorganisms). Detailed analysis of the infectious pathogens have demonstrated the prevalence of coagulase-negative staphylococcus (Staph. epidermidis) – 56.3% (n=40), At the same time, a relatively large percentage was represented by Staphylococcus aureus – 5.7% (n=4), Micrococcus spp. – 1.4% (n=1), Enterococcus spp. – 1.4% (n=1). Gram-negative microorganisms were detected in 26.7% (n=19) of cases: Escherichia coli – 14.1% (n=10) patients, Enterobacter spp. – 5.6% (n=4), Enterobacter aerogenes – 1.4% (n=1), Acinetobacter spp. – 1.4% (n=1), Pseudomonas aeruginosa – 1.4% (n=1), Neisseria spp. – 2.8% (n=2). Causative agents of fungal infections were found for 8.5% of patients (n=6), including fungi of the genus Candida – 7.1% (C. albicans (n=4), C. crusei (n=1), Rhodotorula spp. – 1.4% (n=1).

Conclusion
In patients with HM among catheter-associated infections, coagulase-negative staphylococcal infection (Staph. epidermidis) is most prevalent, which is most likely due to contact route of infection.

Session topic: 31. Transfusion medicine

Keyword(s): Catheter-related thrombosis, Central venous catheter, Complications, Hematological malignancy

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