Browse > Article

Retrospective Analysis for Complications of the Central Venous Catheter in Patients with Cancer at a Single Center in Korea  

Kim, Eun-Jung (Division of Hematology and Oncology, Department of Internal Medicine, Soonchunhyang University College of Medicine)
Kim, Hyun-Jung (Division of Hematology and Oncology, Department of Internal Medicine, Soonchunhyang University College of Medicine)
Kim, Han-Jo (Division of Hematology and Oncology, Department of Internal Medicine, Soonchunhyang University College of Medicine)
Kim, Kyoung-Ha (Division of Hematology and Oncology, Department of Internal Medicine, Soonchunhyang University College of Medicine)
Kim, Se-Hyung (Division of Hematology and Oncology, Department of Internal Medicine, Soonchunhyang University College of Medicine)
Lee, Sang-Cheol (Division of Hematology and Oncology, Department of Internal Medicine, Soonchunhyang University College of Medicine)
Bae, Sang-Byung (Division of Hematology and Oncology, Department of Internal Medicine, Soonchunhyang University College of Medicine)
Kim, Chan-Kyu (Division of Hematology and Oncology, Department of Internal Medicine, Soonchunhyang University College of Medicine)
Lee, Nam-Su (Division of Hematology and Oncology, Department of Internal Medicine, Soonchunhyang University College of Medicine)
Lee, Kyu-Taek (Division of Hematology and Oncology, Department of Internal Medicine, Soonchunhyang University College of Medicine)
Park, Sung-Kyu (Division of Hematology and Oncology, Department of Internal Medicine, Soonchunhyang University College of Medicine)
Won, Jong-Ho (Division of Hematology and Oncology, Department of Internal Medicine, Soonchunhyang University College of Medicine)
Park, Hee-Sook (Division of Hematology and Oncology, Department of Internal Medicine, Soonchunhyang University College of Medicine)
Hong, Dae-Sik (Division of Hematology and Oncology, Department of Internal Medicine, Soonchunhyang University College of Medicine)
Publication Information
Journal of Hospice and Palliative Care / v.13, no.1, 2010 , pp. 24-31 More about this Journal
Abstract
Purpose: A central venous catheterization (CVC) is frequently used for delivering anti-cancer chemotherapeutic agents, blood products, parenteral nutrition, and other intravenous therapy in patients with cancer. Major complications of CVC use are thrombosis, infection, and mechanical complications. The aim of this study was to evaluate the frequency of CVC complications and related factors. Methods: The records of cancer patients who received a CVC at our university hospital from March 2001 to October 2006 were retrospectively investigated. Chi square test was used to determine whether there was a related factor for thrombosis or infection, and Kaplan-Meier analysis for univariate analysis, or Cox-regression analysis for multivariate analysis was used for catheter life span. Results: Three hundred and ten CVCs (235 nontunneled, 75 tunneled) were inserted in 310 patients (157 males, 153 females). Among them, 104 had hematologic cancers and 206 had solid cancers. The mean age of the patients was 52 years (range, 19~82 years). CVC complications occurred in 60 cases (19%). CVC-related thrombosis occurred frequently in patients with infection (P=0.003), whereas diagnosis, catheter type, transfusion, and TPN history did not affect infection or thrombosis. The mean duration of the catheter was 102 days (range, 2~1,330 days), and the duration was prolonged in patients with tunneled catheters (P=0.000), or without transfusion through CVC (P=0.030). Conclusion: The major complications for long-term use of a CVC were infectionand thrombosis. Tunneled catheter was effective tool for long term use, especially in cases without transfusion through CVC. The studies on the prevention or treatment ofthrombosis and infection are, therefore, warranted by using CVC for an extended period of time.
Keywords
Catheterization; Central venous; Hematologic neoplasms/complications; Neoplasms;
Citations & Related Records
Times Cited By KSCI : 1  (Citation Analysis)
연도 인용수 순위
1 Trautner BW, Darouiche RO. Catheter-associated infections: pathogenesis affects prevention. Arch Intern Med 2004;164(8):842-50.   DOI   ScienceOn
2 Brun-Buisson C, Abrouk F, Legrand P, Huet Y, Larabi S, Rapin M. Diagnosis of central venous catheterrelated sepsis. Critical level of quantitative tip cultures. Arch Intern Med 1987;147(5):873-7.   DOI   ScienceOn
3 Catton JA, Dobbins BM, Kite P, Wood JM, Eastwood K, Sugden S, et al. In situ diagnosis of intravascular catheter-related bloodstream infection: a comparison of quantitative culture, differential time to positivity, and endoluminal brushing. Crit Care Med 2005;33(4):787-91.   DOI   ScienceOn
4 Safdar N, Fine JP, Maki DG. Meta-analysis: methods for diagnosing intravascular device-related bloodstream infection. Ann Intern Med 2005;142(6):451-66.   DOI   ScienceOn
5 Raad I, Darouiche R, Dupuis J, Abi-Said D, Gabrielli A, Hachem R, et al. Central venous catheters coated with Minocycline and rifampin for the prevention of catheter related colonization and bloodstream infections: a randomized, double-blind trial. The Texas Medical Center Catheter Study Group. Ann Intern Med 1997;127(4):267-74.   DOI   ScienceOn
6 Kim JT, Oh TY. Clinical review of totally implantable venous catheter. Korean J Thorac Cardiovasc Surg 2007;40(10):691-5.   과학기술학회마을
7 Cho SG, Kim SH, Song HH, Song SH, Lee KH, Chung DY, et al. Radiologic placement of subcutaneous infusion ports in cancer patients: analysis of 45 cases. J Korean Cancer Assoc 2000;32(6): 1115-21.
8 Mansfield PF, Hohn DC, Fornage BD, Gregurich MA, Ota DM. Complications and failures of subclavian-vein catheterization. N Engl J Med 1994;331(26):1735-8.   DOI   ScienceOn
9 Fares LG II, Block PH, Feldman SD. Improved house staff results with subclavian cannulation. Am Surg 1986;52(2):108-11.
10 Bold RJ, Winchester DJ, Madary AR, Gregurich MA, Mansfield PF. Prospective, randomized trial of Doppler-assisted subclavian vein catheterization. Arch Surg 1998;133(10):1089-93.   DOI   ScienceOn
11 Cortelezzi A, Moia M, Falanga A, Pogliani EM, Agnelli G, Bonizzoni E, et al. CATHEM Study Group. Incidence of thrombotic complications in patients with haematological malignancies with central venous catheters: a prospective multicentre study. Br J Haematol 2005;129(6):811-7.   DOI   ScienceOn
12 Ponec D, Irwin D, Haire WD, Hill PA, Li X, McCluskey ER. COOL Investigators. Recombinant tissue plasminogen activator (alteplase) for restoration of flow in occluded central venous access devices: a double-blind placebo-controlled trial-the Cardiovascular Thrombolytic to Open Occluded Lines (COOL) efficacy trial. J Vasc Interv Radiol 2001;12(8):951-5.   DOI   ScienceOn
13 Eggimann P, Hugonnet S, Sax H, Harbarth S, Chevrolet JC, Pittet D. Long-term reduction of vascular access-associated bloodstream infection. Ann Intern Med 2005;142(10):875-6.
14 Ljungman P, Hagglund H, Bjorkstrand B, Lönnqvist B, Ringden O. Peroperative teicoplanin for prevention of Gram-positive infections in neutropenic patients with indwelling central venous catheters: a randomized, controlled study. Support Care Cancer 1997;5(6):485-8.   DOI   ScienceOn
15 Frank DA, Meuse J, Hirsch D, Ibrahim JG, van den Abbeele AD. The treatment and outcome of cancer patients with thromboses on central venous catheters. J Thromb Thrombolysis 2000;10(3):271-5.   DOI   ScienceOn
16 Vescia S, Baumgärtner AK, Jacobs VR, Kiechle-Bahat M, Rody A, Loibl S, et al. Management of venous port systems in oncology: a review of current evidence. Ann Oncol 2008;19(1):9-15.
17 Gallieni M, Pittiruti M, Biffi R. Vascular access in oncology patients. CA Cancer J Clin 2008;58(6):323-46.   DOI   ScienceOn
18 Boersma RS, Jie KS, Verbon A, van Pampus EC, Schouten HC. Thrombotic and infectious complications of central venenous catheters in patients with hematological malignancies. Ann Oncol 2008;19(3):433-42.
19 Merrer J, De Jonghe B, Golliot F, Lefrant JY, Raffy B, Barre E, et al. Complications of femoral and subclavian venous catheterization in critically ill patients: a randomized controlled trial. JAMA 2001;286(6):700-7.   DOI   ScienceOn
20 Monturo CA, Dickerson RN, Mullen JL. Efficacy of thrombolytic therapy for occlusion of long-term catheters. JPEN J Parenter Enteral Nutr 1990;14(3):312-4.   DOI   ScienceOn
21 Carr KM, Rabinowitz I. Physician compliance with warfarin prophylaxis for central venous catheters in patients with solid tumors. J Clin Oncol 2000;18(21):3665-7.   DOI
22 Baskin JL, Pui CH, Reiss U, Wilimas JA, Metzger ML, Ribeiro RC, et al. Management of occlusion and thrombosis associated with long-term indwelling central venous catheters. Lancet 2009;374(9684):159-69.   DOI   ScienceOn
23 Young AM, Billingham LJ, Begum G, Kerr DJ, Hughes AI, Rea DW, et al. WARP Collaborative Group, UK. Warfarin thromboprophylaxis in cancer patients with central venous catheters (WARP): an open label randomised trial. Lancet 2009;373(9663):567-74.   DOI   ScienceOn
24 Mermel LA, Farr BM, Sherertz RJ, Raad II, O'Grady N, Harris JS, et al. Infectious Diseases Society of America; American College of Critical Care Medicine; Society for Healthcare Epidemiology of America. Guidelines for the management of intravascular catheterrelated infections. Clin Infect Dis 2001;32(9):1249-72.   DOI   ScienceOn
25 Nouwen JL, Wielenga JJ, van Overhagen H, Lameris JS, Kluytmans JA, Behrendt MD, et al. Hickman catheter-related infections in neutropenic patients: insertion in the operating theater versus insertion in the radiology suite. J Clin Oncol 1999;17(4):1304.   DOI
26 Lee AY, Levine MN, Butler G, Webb C, Costantini L, Gu C, et al. Incidence, risk factors, and outcomes of catheter-related thrombosis in adult patients with cancer. J Clin Oncol 2006;24(9):1404-8.   DOI   ScienceOn
27 Cortelezzia A, Fracchiolla NS, Maisonneuve P, Moia M, Luchesini C, Ranzi ML, et al. Central venous catheter related complications in patients with hematological malignancies: a retrospective analysis of risk factors and prophylactic measures. Leuk Lymphoma 2003;44(9):1495-501.   DOI   ScienceOn
28 Monreal M, Raventos A, Lerma R, Ruiz J, Lafoz E, Alastrue A, et al. Pulmonary embolism in patients with upper extremity DVT associated to venous central lines-a prospective study. Thromb Haemost 1994;72(4):548-50.
29 Martin C, Viviand X, Saux P, Gouin F. Upper-extremity deep vein thrombosis after central venous catheterization via the axillary vein. Crit Care Med 1999;27(12):2626-9.   DOI   ScienceOn
30 Monreal M, Lafoz E, Ruiz J, Valls R, Alastrue A. Upper-extremity deep venous thrombosis and pulmonary embolism. A prospective study. Chest 1991;99(2):280-3.   DOI   ScienceOn
31 Prandoni P, Polistena P, Bernardi E, Cogo A, Casara D, Verlato F, et al. Upper-extremity deep vein thrombosis. Risk factors, diagnosis, and complications. Arch Intern Med 1997;157(1):57-62.   DOI   ScienceOn
32 Journeycake JM, Buchanan GR. Catheter-related deep venous thrombosis and other catheter complications in children with cancer. J Clin Oncol 2006;24(28):4575-80.   DOI   ScienceOn
33 Buller HR, Agnelli G, Hull RD, Hyers TM, Prins MH, Raskob GE. Antithrombotic therapy for venous thromboembolic disease: the Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy. Chest 2004;126(3 Suppl):401S-28S.   DOI
34 Karabay O, Yetkin U, Onol H. Upper extremity deep vein thrombosis: clinical and treatment characteristics. J Int Med Res 2004;32(4):429-35.   DOI   ScienceOn
35 Veenstra DL, Saint S, Saha S, Lumley T, Sullivan SD. Efficacy of antiseptic-impregnated central venous catheters in preventing catheter-related bloodstream infection: a meta-analysis. JAMA 1999;281(3):261-7.   DOI   ScienceOn
36 Mansfield PF, Hohn DC, Fornage BD, Gregurich MA, Ota DM. Complications and failures of subclavian-vein catheterization. N Engl J Med 1994;331(26):1735-8.   DOI   ScienceOn
37 Lordick F, Hentrich M, Decker T, Hennig M, Pohlmann H, Hartenstein R, et al. Ultrasound screening for internal jugular vein thrombosis aids the detection of central venous catheterrelated infections in patients with haemato-oncological diseases: a prospective observational study. Br J Haematol 2003;120(6):1073-8.   DOI   ScienceOn
38 Lefrant JY, Cuvillon P, Benezet JF, Dauzat M, Peray P, Saissi G, et al. Pulsed Doppler ultrasonography guidance for catheterization of the subclavian vein: a randomized study. Anesthesiology 1998;88(5):1195-201.   DOI   ScienceOn
39 van Rooden CJ, Rosendaal FR, Barge RM, van Oostayen JA, van der Meer FJ, Meinders AE, et al. Central venous catheter related thrombosis in haematology patients and prediction of risk by screening with Doppler-ultrasound. Br J Haematol 2003;123(3): 507-12.   DOI   ScienceOn
40 Xiang DZ, Verbeken EK, Van Lommel AT, Stas M, De Wever I. Composition and formation of the sleeve enveloping a central venous catheter. J Vasc Surg 1998;28(2):260-71.   DOI   ScienceOn
41 Van Rooden CJ, Monraats PS, Kettenis IM, Rosendaal FR, Huisman MV. Low physician compliance of prescribing anticoagulant prophylaxis in patients with solid tumor or hematological malignancies and central vein catheters. J Thromb Haemost 2003;1(8):1842-3.   DOI   ScienceOn
42 Hospital Infection Control Practices Advisory Committee (HICPAC). Recommendations for preventing the spread of vancomycin resistance. Infect Control Hosp Epidemiol 1995;16(2):105-13.   DOI   ScienceOn