Intravenous access: related problems in oncology.

Area of Science:

• Oncology
• Infectious Diseases
• Medical Devices

Background:

• Hickman central venous catheters (CVCs) and totally implanted venous ports are crucial in oncology.
• Catheter-related bloodstream infections (CRBI) pose a significant risk to patients.

Purpose of the Study:

• To review recent advancements in diagnosing and managing CRBI in oncology patients.
• To present a decision-tree for CRBI management without device removal.
• To explore future trends in CRBI prevention and treatment.

Main Methods:

• Literature review of recent developments concerning CVCs and venous ports.
• Analysis of international data to create a CRBI management decision-tree.
• Review of emerging techniques for CRBI prevention and treatment.

Main Results:

• Paired quantitative blood cultures are identified as a reliable method for diagnosing CRBI without device removal.
• A decision-tree/flow-chart for managing CRBI has been developed by international experts.
• New preventive strategies include antimicrobial-impregnated catheters and antiseptic hubs.

Conclusions:

• CRBI diagnosis can be achieved non-invasively, facilitating timely treatment.
• Device removal may not always be necessary for CRBI cure.
• Innovative prevention and treatment methods, including antibiotic lock techniques, are advancing CRBI management.