Influence of Prolonged Use of Intravenous Administration Sets in Paediatric Cancer Patients on CVAD-related Bloodstream Infection Rates and Hospital Resources

Abstract

Extending the routine IVAS change-interval from 3 days to 7 days appears to be safe and cost-effective in a paediatric oncology unit with high infection control standards and continuous surveillance for NIs. These results do not prove that 7-day intervals prevent infections, but they do suggest that this policy probably is not harmful and that a prospectively randomized study with sufficient power is needed.

Bloodstream Infections in Paediatric Cancer Patients. Prospective Comparative Study in 2 University Hospitals

“…In Center A, CVADs were implanted prior to induction chemotherapy in children with acute lymphoblastic leukaemia (in contrast to the practice to postpone the CVAD implantation after day 33 in Center B) [ 11 ] . Intravenous administration sets were routinely changed after 7 days (compared to every 48 h in Center B) [ 27 ] and Broviacs were fl ushed only once a week (compared to twice a week in Center B). Only in Center A, a silver impregnated Broviac catheter (VYGON Lifecath™) was used in 30 of 84 patients with at least 1 CVAD (36 %).…”

Taurolidine-citrate lock solution (TauroLock) significantly reduces CVAD-associated grampositive infections in pediatric cancer patients

“…The CVAD clinical-practice recommendations of the German Society of Pediatric Oncology and Hematology (GPOH) have been coordinated by one of the authors (AS), are strictly followed during in- and outpatient care, and fully match the CDC-Recommendations [ 25 ] with the following exceptions: octendine 0.1%/phenoxyethanol 2% (Octenisept ® , Schuelke & Mayr, Norderstedt) is used for local antisepsis [ 26 , 27 ]. In addition, intravenous administration sets are changed routinely only once a week [ 28 ] unless they have been used for lipid infusion (once a day) or for blood product administration (6 hours after the transfusion) [ 29 ]. In this pediatric oncology unit, totally implanted port catheters are preferably used in patients with conventional chemotherapy regimens (median duration of neutropenia <7 days).…”

Bloodstream infection in paediatric cancer centres—leukaemia and relapsed malignancies are independent risk factors

“…The methods of the Oncoped module have been described in previous publications [34,47,48,51,52,54]. Data entry into the intranet-based documentation tool 1 was activated on November 01, 2007 and closed on July 31, 2010.…”