A retrospective study of central venous catheters GCRI experience

Abstract

Background:The use of central venous catheters (CVCs) has greatly improved the quality-of-care in cancer patients, yet these catheters may cause serious infectious and thrombotic complications. The aim of this retrospective study was to study the various types of CVCs and their complications.Materials and Methods:We studied retrospectively 213 cases of CVCs in our institute with their indications, type and complications from August 2010 to July 2011.Results:A total of 213 CVCs were inserted in patients with hematological (62%) and solid organ malignancies (38%). Ninety-eight patients (46%) had peripheral inserted central catheter (PICC), 90 (42%) patients had Hickman catheters and 25 (12%) had a port. The median duration of retention of Hickman catheters was 104 days (3-365 days), for the peripherally inserted central catheters was 59 days (3-100 days) and for the port it was 280 days (45-365 days). Non-infective complications were more than infective (12% vs. 7%). The most common complication was non-infective occlusion and thrombophlebitis. In one patient with PICC thrombosis occurred in the cephalic, radial and ulnar vein and in one patient with port thrombosis occurred in the superior vena cava. Organisms were isolated in 60% (12 out of 20) of cultures. Common organisms isolated were Pseudomonas aeruginosa in 5 (42%), Staphylococcus aureus in 2 (16%), Escherichia coli in 2 (16%) and Aspergillus in 3 (25%) patients. 7 out of 12 infected patients had negative blood cultures within 7 days of antibiotic treatment, 5 patients remained positive for more than 7 days with antibiotics. In 155 patients (73%), the desired treatment protocol was completed and at present there are still 28 patients (13%) with catheters. 5 patients (2.3%) died of febrile neutropenia and septicemia with multi-organ failure. In 5 patients (2.3%), the catheters (1 Port, 1 Hickman and 3 PICC) were prematurely removed because of thrombosis.Conclusion:CVCs are better options to facilitate the long-term vascular access provided infection is prevented with meticulous care and treated promptly with proper antibiotics. Most CVCs is acceptable to patients.

Molecular analysis, biofilm formation, and susceptibility of methicillin-resistant Staphylococcus aureus strains causing community- and health care-associated infections in central venous catheters

“…The prevalence of MRSA (59%; 203/344) among CVC-related infections agreed with the results of previous similar studies 42,43 . In India, P. aeruginosa was found to be the most common cause (42%) of CVC infection, which contradicted our study because the previous study was conducted in only cancer patients 44 .…”

Outcomes, cost comparison, and patient satisfaction during long-term central venous access in cancer patients: Experience from a Tertiary Care Cancer Institute in South India

“…Jain et al . [3] had 19% overall complication incidence with 12% mechanical and 7% infective. Kim et al .…”

“…Jain et al . [3] found the most common isolate to be P. aeruginosa . We managed to salvage 18 out of 31 CVC/PICC and two out of three CPs.…”

“Peripherally Inserted Central Catheters: Our Experience from a Cancer Research Centre”

“…Previous studies have shown a variable rate of infective complications. Walshe LJ et al reported 7.4 % rate of catheter related blood stream infections while another study from India has reported an incidence rate of 7 % for infective complications [5,6]. A study done by Barrier A et al reported the incidence of infective complications in PICCs as 11.1 %, while Chen W et al reported the incidence of infections associated with PICCs as 17.6 % [7,8].…”