Vascular access for apheresis: State of the art

Mustieles, María-Jesús; Lozano, Miquel

doi:10.1016/j.transci.2023.103669

Cited by 1 publication

(3 citation statements)

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“…18,44 Some studies emphasize the implementation of an ultrasound system for cannulating peripheral veins as one of the most useful improvements in an apheresis unit. 9, 45 Mustieles and Lozano described their experience with the ultrasound-guided cannulation which dramatically decreased CVC placement from 30% to 0% in autologous PBSC collections. 45 Their results emphasized the importance of intensive training of their nurse team in using ultrasound, beginning with an online course (www.usabcd.org), followed by a course taught by their hospital staff including a practical part with a defined number of cannulations, and finally, 15-hours course given by an experienced apheresis nurse from another institution.…”

Section: Discussionmentioning

confidence: 99%

“…9, 45 Mustieles and Lozano described their experience with the ultrasound-guided cannulation which dramatically decreased CVC placement from 30% to 0% in autologous PBSC collections. 45 Their results emphasized the importance of intensive training of their nurse team in using ultrasound, beginning with an online course (www.usabcd.org), followed by a course taught by their hospital staff including a practical part with a defined number of cannulations, and finally, 15-hours course given by an experienced apheresis nurse from another institution. Although ultrasound evaluation of peripheral veins is a desirable option, it still has not been implemented in our institution due to organizational and financial limitations.…”

Section: Discussionmentioning

confidence: 99%

“…McDiarmid et al, as well as Padmanabhan, highlighted the importance of apheresis team training and thus the final choice of appropriate venous access should be made following a vein assessment by an experienced nurse 18,44 . Some studies emphasize the implementation of an ultrasound system for cannulating peripheral veins as one of the most useful improvements in an apheresis unit 9,45 . Mustieles and Lozano described their experience with the ultrasound‐guided cannulation which dramatically decreased CVC placement from 30% to 0% in autologous PBSC collections 45 .…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Vascular access for autologous peripheral blood stem cells collection by large volume leukapheresis: Single center experience

Bojanić,

Novosel,

Lukač Baričević

et al. 2023

J of Clinical Apheresis

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IntroductionPeripheral blood stem cell (PBSC) harvesting requires reliable and safe vascular access. In our institution, a change of practice was implemented and the central venous catheter (CVC) placement for all autologous PBSC collections was abandoned in favor of a careful evaluation of peripheral venous access (PVA) for each individual patient. The aim of this prospective study was to evaluate the rate of patients with adequate peripheral veins for autologous PBSC collection and compare patient characteristics, collection efficacy, and complication rate between patients with PVA and CVC.MethodPeripheral veins were assessed by the apheresis nurse team in all patients referred between January 2020 and July 2021 to autologous PBSC collection. Only in case of difficult venous access, CVC was inserted. Large volume leukapheresis (LVL) procedures, which processed ≥3 total blood volumes, were performed.ResultsIn 65 (57%) patients PVA was used, while 49 (43%) patients required placement of short‐term CVC. Peripheral venous access was successfully used significantly more often in males (69.8%) (P = 0.010), and patients with multiple myeloma (71.0%) than in patients with non‐Hodgkin's lymphoma (35.9%) and Hodgkin's lymphoma patients (33.3%) (P < 0.001). There was a significant difference in the type of prior administered chemotherapy; in the patients who received cytostatics free chemotherapy, PVA was used more often (75.0%) (P = 0.007). In terms of the efficacy and safety of LVLs, there were no differences between procedures performed using PVA and CVCs.ConclusionPeripheral venous access is feasible for autologous PBSC collection in more than a half of patients, in particular in those with multiple myeloma. Changes in the treatment of multiple myeloma, using new proteasome inhibitors‐based and immunomodulatory agents that do not adversely affect peripheral veins, have enabled the use of PVA even at the high blood flow rates required by LVL. Peripheral venous access is not associated with safety issues or with a lesser collection efficiency, and it is cost‐effective as well. Each patient referred to autologous PBSC collection needs to be evaluated individually by the experienced apheresis team for the most appropriate venous access.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%