Contributions
Abstract: EP836
Type: E-Poster Presentation
Session title: Infections in hematology (incl. supportive care/therapy)
Background
The central vascular access needs to provide a large volume of infusion therapy, a parenteral feeding, transfusions of the blood components in hematology patients (HP). However, the procedure of central vein catheterization (CVC) may lead to risks of serious complications.
Aims
To find out the incidence of individual complications associated with CVC in HP.
Methods
We studied the complications associated with procedure of CVC in HP (n=2856) for the period of above 17 years (2003-2020 years). Most procedures were performed by subclavian access (into the v. subclavia dextra – in 2346 (82.1%) cases and into v. subclavia sinistra – 502 (17.6%)), only 8 cases (0.3%) into v. jugularis interna. After each CVC procedure was done X-ray control. There were performed bacteriological analyses and identification of microbial pathogen in cases if we suspected an infectious complication.
Results
There were observed range of complications associated with CVC. The more frequently were found hemorrhagic complications: 1) hematoma – in 117 cases (4.1%), 2) puncture of an artery – in 79 (2.8%), and one case catheterization of arteria subclavian, 3) bleeding from the catheter passage area – in 54 (1.9%), 4) delayed bleeding (after 3-4 hours or more) – in 24 cases (0.8%), and 5) clinically significant lymphorrhea – in 41 cases (1.4%). The thrombotic complications included thrombophlebitis, infiltrate with thrombosis of subclavian vein and they were counted 74 cases (2.6%). Most of thrombotic complications were associated with different bacterial pathogens. More rarely we documented complications as pain, numbness, paresthesia of the upper limb were observed in 45 patients (1.6%), as well as weakness, allergic Quincke’s edema, fainting or collapse associated with anesthesia were observed in 34 ones (1.2%). Among the dangerous clinically significant complications that required additional measures were pneumothorax (n=3; 0.11%) and pneumothorax with hemoptysis (n=2; 0.07%). The complications associated with bloodstream infection in the form of bacteremia or fungeremia, which were observed by bacteriological culture, were detected in 71 (2.5%) patients. Positive bacterial cultures from venous blood were detected in 89 cases, and 12 blood probes of them had mixed infection (2 and rarely 3 bacterial pathogens). Analysis of the different microorganisms indicated the prevalence of Gram-positive pathogens – 61.8% (n=55): the most part was Coagulase-negative Staphylococcus – 50.6% (n=45), S. aureus – 9.0% (n=8), Enterococcus spp. – 1.1% (n=1) and Micrococcus spp. – 1.1% (n=1). Gram-negative microorganisms were detected in 30.4% (n=27) of cases: Escherichia coli – 15.7% (n=14) patients, Enterobacter spp. – 9.0% (n=8), Acinetobacter spp. – 1.1% (n=1), Pseudomonas aeruginosa – 2.3% (n=2), Neisseria spp. – 2.3% (n=2). Causative agents of fungal infections were found for 7.8% of patients (n=7). They included fungi of the genus Candida – 6.7% (C. albicans – 5.6% (n=5), C. crusei – 1.1% (n=1)) and Rhodotorula spp. – 1.1% (n=1).
Conclusion
we found the most of CVC’s complications were associated with hemorrhagic as hematoma (4.1%), its rate depended on thrombocytopenia, coagulation disorders and technic of procedure in HP. Blood stream infections associated with CVC were caused by gram-positive microbes in more cases (coagulase-negative Staphylococcus), little less by gram-negative (Escherichia coli).
Keyword(s): Bleeding, Blood transfusion, Catheter-related thrombosis, Central venous catheter
Abstract: EP836
Type: E-Poster Presentation
Session title: Infections in hematology (incl. supportive care/therapy)
Background
The central vascular access needs to provide a large volume of infusion therapy, a parenteral feeding, transfusions of the blood components in hematology patients (HP). However, the procedure of central vein catheterization (CVC) may lead to risks of serious complications.
Aims
To find out the incidence of individual complications associated with CVC in HP.
Methods
We studied the complications associated with procedure of CVC in HP (n=2856) for the period of above 17 years (2003-2020 years). Most procedures were performed by subclavian access (into the v. subclavia dextra – in 2346 (82.1%) cases and into v. subclavia sinistra – 502 (17.6%)), only 8 cases (0.3%) into v. jugularis interna. After each CVC procedure was done X-ray control. There were performed bacteriological analyses and identification of microbial pathogen in cases if we suspected an infectious complication.
Results
There were observed range of complications associated with CVC. The more frequently were found hemorrhagic complications: 1) hematoma – in 117 cases (4.1%), 2) puncture of an artery – in 79 (2.8%), and one case catheterization of arteria subclavian, 3) bleeding from the catheter passage area – in 54 (1.9%), 4) delayed bleeding (after 3-4 hours or more) – in 24 cases (0.8%), and 5) clinically significant lymphorrhea – in 41 cases (1.4%). The thrombotic complications included thrombophlebitis, infiltrate with thrombosis of subclavian vein and they were counted 74 cases (2.6%). Most of thrombotic complications were associated with different bacterial pathogens. More rarely we documented complications as pain, numbness, paresthesia of the upper limb were observed in 45 patients (1.6%), as well as weakness, allergic Quincke’s edema, fainting or collapse associated with anesthesia were observed in 34 ones (1.2%). Among the dangerous clinically significant complications that required additional measures were pneumothorax (n=3; 0.11%) and pneumothorax with hemoptysis (n=2; 0.07%). The complications associated with bloodstream infection in the form of bacteremia or fungeremia, which were observed by bacteriological culture, were detected in 71 (2.5%) patients. Positive bacterial cultures from venous blood were detected in 89 cases, and 12 blood probes of them had mixed infection (2 and rarely 3 bacterial pathogens). Analysis of the different microorganisms indicated the prevalence of Gram-positive pathogens – 61.8% (n=55): the most part was Coagulase-negative Staphylococcus – 50.6% (n=45), S. aureus – 9.0% (n=8), Enterococcus spp. – 1.1% (n=1) and Micrococcus spp. – 1.1% (n=1). Gram-negative microorganisms were detected in 30.4% (n=27) of cases: Escherichia coli – 15.7% (n=14) patients, Enterobacter spp. – 9.0% (n=8), Acinetobacter spp. – 1.1% (n=1), Pseudomonas aeruginosa – 2.3% (n=2), Neisseria spp. – 2.3% (n=2). Causative agents of fungal infections were found for 7.8% of patients (n=7). They included fungi of the genus Candida – 6.7% (C. albicans – 5.6% (n=5), C. crusei – 1.1% (n=1)) and Rhodotorula spp. – 1.1% (n=1).
Conclusion
we found the most of CVC’s complications were associated with hemorrhagic as hematoma (4.1%), its rate depended on thrombocytopenia, coagulation disorders and technic of procedure in HP. Blood stream infections associated with CVC were caused by gram-positive microbes in more cases (coagulase-negative Staphylococcus), little less by gram-negative (Escherichia coli).
Keyword(s): Bleeding, Blood transfusion, Catheter-related thrombosis, Central venous catheter