Evidence-Based Criteria for the Choice and the Clinical use of the Most Appropriate Lock Solutions for Central Venous Catheters (Excluding Dialysis Catheters): A GAVeCeLT Consensus

Pittiruti, Mauro; Bertoglio, Sergio; Scoppettuolo, Giancarlo; Biffi, Roberto; Lamperti, Massimo; Molin, Alberto Dal; Panocchia, Nicola; Petrosillo, Nicola; Venditti, Mario; Rigo, Carla; DeLutio, Enrico

doi:10.5301/jva.5000576

Cited by 65 publications

(92 citation statements)

References 85 publications

(116 reference statements)

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“…Unfortunately, a great deal of the CLABSI episodes will still result in removal of the CVAD owing to continuing symptoms, relapses or reinfections. In the prevention of CLABSIs, the use of lock solutions containing taurolidine, ethanol or citrate appears to be promising; however, further research on this subject is needed and strongly recommended [11,29,[32][33][34][35]. Patients diagnosed with hematooncologic malignancies were more at risk for CVAD-related complications in general; this might be because of more frequent CVAD-manipulation in this patient group [1,7,9].…”

Section: Microorganismsmentioning

confidence: 93%

“…Currently in the Netherlands, CVADs are locked with heparin. However, the heparin lock appears to be of limited value in the prevention of malfunction [29]. Preventing malfunction of the CVAD should instead be accomplished by the education of health care providers about the maintenance of CVADs and by working more protocolized; use more proper flushing policies, needle-free connectors, and no-reflux strategies (e.g.…”

Section: Microorganismsmentioning

confidence: 99%

“…Preventing malfunction of the CVAD should instead be accomplished by the education of health care providers about the maintenance of CVADs and by working more protocolized; use more proper flushing policies, needle-free connectors, and no-reflux strategies (e.g. a no-reflux syringe) [29]. Future research needs to address the best lock solution for the prevention of CVAD malfunction in this patient population.…”

Section: Microorganismsmentioning

confidence: 99%

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Incidence, severity and outcome of central line related complications in pediatric oncology patients; A single center study

Bosch

Bruggen

Frakking

et al. 2019

Journal of Pediatric Surgery

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Background: Central venous access device (CVAD)-related complications are associated with high morbidity rates. This study was performed to underline the importance of CVAD-complication prevention and treatment. Methods: An audit of practice of CVAD-related complications in pediatric oncology patients receiving a CVAD between January 2015 and June 2017 was performed. CVADs included were totally implantable venous access ports (TIVAPs), Hickman-Broviac® (HB), nontunneled, and peripherally inserted CVADs. Results: A total of 201 children, with 307 CVADs, were analyzed. The incidence rates per 1000 CVAD-days for the most common complications were 1.66 for malfunctions, and 1.51 for central line-associated bloodstream infections (CLABSIs). Of all CVADs inserted, 37.1% were removed owing to complications, of which 45.6% were owing to CLABSIs. In 42% of the CLABSIs, the CLABSI could be successfully cured with systemic antibiotic treatment only. Of all included patients, 5.0% were admitted to the intensive care unit owing to CLABSI. The HB-CVAD compared to the TIVAP was a risk factor for CVAD-related complications, CLABSIs and dislocations in particular. Conclusions: The incidence of CVAD-related complications is high. Research on the prevention and treatment of CVAD-related complications in pediatric oncology patients should be a high priority for all health care professionals. Type of study: Prognosis study (retrospective).

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Section: Microorganismsmentioning

confidence: 93%

Section: Microorganismsmentioning

confidence: 99%

Section: Microorganismsmentioning

confidence: 99%

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Incidence, severity and outcome of central line related complications in pediatric oncology patients; A single center study

Bosch

Bruggen

Frakking

et al. 2019

Journal of Pediatric Surgery

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“…Zusammenfassend kann Kochsalzlösung im Vergleich zu Lösungen aus der Gruppe der Antikoagulanzien in Bezug auf die Verhinderung einer Katheterblockade als gleichwertig angesehen werden [13].…”

Section: Methodeunclassified

Heparin gegen Katheterblockaden – ist das notwendig?

Thalmann¹,

Schlüer²,

Koppitz³

et al. 2019

JuKiP

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Die aktuellen Empfehlungen sowie die Umsetzung in der klinischen Praxis zur Prävention von Katheterblockaden bei zentralvenösen Kathetern variieren stark. Der routinemäßige Gebrauch von Heparin ist nach wie vor weitverbreitet. Die Debatte, Kochsalzlösung als gleichwertige Lösung anstelle von Heparin sowohl zum Spülen als auch Blocken der Katheter zu verwenden, ist groß. Studien zeigen, dass der Gebrauch von Heparin nicht ohne Risiken, möglicherweise unnötig und mit höheren Kosten verbunden ist. Die Anwendung von Heparin sollte deshalb in der Praxis kritisch hinterfragt werden und es sollte eine sorgfältige Abwägung des Nutzens im einzelnen Fall erfolgen.

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“…As oclusões trombóticas são mais severas do que as demais, pois aumentam o risco de trombose vascular relacionada ao cateter. Além disso, a fibrina favorece o crescimento de bactéria e infecção 12,13 .…”

Section: Introductionunclassified

Manutenção da permeabilidade dos dispositivos de acesso venoso central em pacientes com câncer

Cabrera

Suguimoto²,

Dini³

et al. 2019

Rev. enferm. UERJ

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Objetivo: atualizar o conhecimento sobre a manutenção da permeabilidade dos Dispositivos de Acesso Vascular Central (DAVC) em paciente com câncer. Conteúdo: os pacientes que fazem uso de quimioterápicos muitas vezes necessitam de DAVC seguros e de longa permanência; a obstrução ocorre em 36% dos pacientes com DAVC inseridos no período de 2 anos, que pode ser classificada como mecânica, por precipitação de medicamento/minerais e pela formação de coágulos. A equipe de enfermagem é responsável por realizar os cuidados para manter a permeabilidade desses dispositivos através do Flushing e Locking. O uso de heparina demonstrou baixa evidência quando comparado ao Soro Fisiológico (SF), em relação a diminuição da obstrução. Conclusão: o uso de SF na manutenção dos DAVC mostra-se seguro, eficaz e com menor custo financeiro.

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Evidence-Based Criteria for the Choice and the Clinical use of the Most Appropriate Lock Solutions for Central Venous Catheters (Excluding Dialysis Catheters): A GAVeCeLT Consensus

Abstract: The actual value of heparinization for non-dialysis catheters should be reconsidered. Also, the use of lock with substances with anti-bacterial and anti-biofilm activity (such as citrate or taurolidine) should be taken into consideration in selected populations of patients.

Cited by 65 publications

References 85 publications

Incidence, severity and outcome of central line related complications in pediatric oncology patients; A single center study

Incidence, severity and outcome of central line related complications in pediatric oncology patients; A single center study

Heparin gegen Katheterblockaden – ist das notwendig?

Manutenção da permeabilidade dos dispositivos de acesso venoso central em pacientes com câncer

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