Infectious Morbidity Associated with Long-Term Use of Venous Access Devices in Patients with Cancer

Groeger, Jeffrey S.

doi:10.7326/0003-4819-119-12-199312150-00003

Cited by 406 publications

(220 citation statements)

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“…However, in a randomized study of infectious morbidity in patients with solid tumors, chemoports were shown to be associated with fewer infections than other catheters [8]. Compared with catheters, chemoports are irrigated less frequently, Fig.…”

Section: Discussionmentioning

confidence: 99%

Totally Implantable Venous Access Devices in Children Requiring Long-Term Chemotherapy: Analysis of Outcome in 122 Children from a Single Institution.

Shankar

Jadhav

Ravindra

et al. 2016

Indian J Surg Oncol

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Children with malignancy require venous access that is reliable, safe and compliant on a long-term basis. There is little data available on utilization of totally implantable venous access devices (TIVAD) for long term chemotherapy in children in an Indian setting [1]. We report our long-term follow-up results of utilization of totally implantable venous access devices for long-term chemotherapy in children. This was a retrospective analysis of 122 children requiring longterm chemotherapy done between January 2008 and December 2013. Data collected included primary disease process, type of port, site of insertion, intraoperative events, early and late postoperative complications, and issues with utilization, maintenance and removal. 127 ports were placed in 122 children. The follow up ranged from 16 to 50 months. Internal jugular vein was accessed in 96.8 % of cases (123/127). Majority of children (61 %) had hematological malignancy. Early complications occurred in 5 children. Late complications occurred in 18 children which included port pocket infection in 3, port site skin issues in 5, catheter related issues in 3, venous thrombosis in 2 and catheter related bacteremia in 5 children respectively. Only 10 children have been lost to follow-up either due to death or discontinuation of treatment and rest are on follow up. Totally implantable venous access devices usage is safe and reliable for access needs in children for longterm chemotherapy. Their low complication and low cost maintenance should increase their utilization in children requiring long-term chemotherapy. Chemoport placement in children with hematological malignancy can be carried out safely without much impact on complication rates. Though management and compliance of children with malignancy has improved; critical analysis and standardization of port system care through prospective trials are necessary to reduce the morbidity and for cost analysis in these children.

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Section: Discussionmentioning

confidence: 99%

Totally Implantable Venous Access Devices in Children Requiring Long-Term Chemotherapy: Analysis of Outcome in 122 Children from a Single Institution.

Shankar

Jadhav

Ravindra

et al. 2016

Indian J Surg Oncol

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“…However, CVC-related episodes accounted for 40% of episodes in patients receiving allogeneic BMT, but only 8% in patients receiving autologous BMT (P Ͻ 0.001). This particular aspect could be due to the fact that patients undergoing allogeneic BMT use CVC, for a longer period because of the complexity of their management in the post-transplant period (eg for control of GVHD or CMV infection) and are therefore exposed to major risk because of the frequent necessity for venous access, [10][11][12][13] perhaps by parents at home. 13,14 However, we have no data to support this supposition.…”

Section: Discussionmentioning

confidence: 99%

Bloodstream infections can develop late (after day 100) and/or in the absence of neutropenia in children receiving allogeneic bone marrow transplantation

Romano

Castagnola

Dallorso

et al. 1999

Bone Marrow Transplant

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Summary:We retrospectively evaluated the incidence and time from transplantation of bloodstream infections occurring in children receiving bone marrow transplant (BMT) at G Gaslini Children's Hospital between September 1984 and December 1997. During this period the incidence was 35% after allogeneic and 26% after autologous BMT (P = 0.08). Among these episodes, 38% after allogeneic BMT and 90% after autologous BMT were detected in the presence of neutropenia within the first 30 days from reinfusion (P Ͻ Ͻ Ͻ 0.001). Incidence of catheter-related bloodstream infections was 40% after allogeneic and 8% after autologous BMT (P Ͻ Ͻ Ͻ 0.001). Bloodstream infections in the absence of neutropenia were 55% after allogeneic BMT vs 10% after autologous BMT (P Ͻ Ͻ Ͻ 0.001) and occurred later after reinfusion (mean 199 vs 41 days, P Ͻ Ͻ0.001). Among the episodes occurring after allogeneic BMT and in the absence of neutropenia, 61% were related to the presence of a central venous catheter, 15% were related to the presence of GVHD, but 23% were not associated with any of major risk factors for infection. Finally, 38% of episodes following allogeneic BMT were detected after day 100 vs 1% after autologous BMT. We concluded that patients receiving allogeneic BMT experience a high incidence of bloodstream infections in the absence of neutropenia and that a significant proportion of these episodes is not clearly associated with well known risk factors such as GVHD or central venous catheters. Moreover, many episodes develop a long time after the transplantation procedure. Therefore, any febrile episode following allogeneic BMT even late and/or in the absence of neutropenia should be intensively managed.

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“…[1,2] Although TIVAPS are generally associated with a lower long-term risk of infection compared to Hickman-type central venous catheters, [3,4] complications during their placement and long-term use are still a matter of concern. These complications, including infection, catheter fracture, thrombosis and extravasation [5,6,7], may necessitate device replacement, resulting in additional patient stress and treatment delays.…”

Section: Introductionmentioning

confidence: 99%

Totally implantable venous access port systems and risk factors for complications: A one-year prospective study in a cancer centre

Narducci¹,

Jean-Laurent²,

Boulanger³

et al. 2011

European Journal of Surgical Oncology (EJSO)

109

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This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. M A N U S C R I P T A C C E P T E D ACCEPTED MANUSCRIPT AbstractBackground: Totally Implantable Venous Access Port Systems (TIVAPS) are widely

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Infectious Morbidity Associated with Long-Term Use of Venous Access Devices in Patients with Cancer

Cited by 406 publications

References 0 publications

Totally Implantable Venous Access Devices in Children Requiring Long-Term Chemotherapy: Analysis of Outcome in 122 Children from a Single Institution.

Totally Implantable Venous Access Devices in Children Requiring Long-Term Chemotherapy: Analysis of Outcome in 122 Children from a Single Institution.

Bloodstream infections can develop late (after day 100) and/or in the absence of neutropenia in children receiving allogeneic bone marrow transplantation

Totally implantable venous access port systems and risk factors for complications: A one-year prospective study in a cancer centre

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