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Fate of right atrial catheters inserted prior to arrival at a transplant center
Insights
Patients undergoing marrow transplantation with pre-inserted right atrial catheters (RACs) did not require routine replacement. Double lumen RACs are recommended for adult patients anticipating transplantation.
Area of Science:
- Medical research
- Hematology
- Transplant surgery
Background:
- Catheter-related complications are a concern in marrow transplantation.
- Right atrial catheters (RACs) are commonly used for vascular access.
Purpose of the Study:
- To compare complication rates of pre-inserted RACs versus RACs inserted at the transplant center.
- To evaluate the necessity of replacing existing RACs before marrow transplantation.
Main Methods:
- Retrospective analysis of 83 patients with pre-inserted RACs (study group).
- Comparison with 357 patients who had RACs inserted at the transplant center (control group).
- Data collection on catheter removal due to complications (septicemia, mechanical).
Main Results:
- Similar complication rates between study (17%) and control (16%) groups.
- Double lumen catheters in the study group had low complication rates (15%).
- Older patients (≥13 years) with single lumen RACs sometimes required additional access.
Conclusions:
- Pre-inserted RACs generally do not require replacement before marrow transplantation.
- Recommends double lumen catheters for adult patients undergoing marrow transplantation.
- Highlights the importance of appropriate catheter selection for vascular access needs.
Abstract:
An analysis of catheter-related complications in a study group consisting of 83 patients, each of whom arrived at a major marrow transplant center after having had a large bore right atrial catheter (RAC) inserted by the referring institution, was compared to a similar analysis of catheter-related complications in 357 patients who had their RAC inserted at the transplant center just before the transplant procedure was begun (control group). Fourteen (17%) patients in the study group had their original catheter removed for complications (five for septicemia and nine for mechanical complications) compared to 57 (16%) of the patients in the control group. Thirteen (16%) of the 83 catheters in the study group were double lumen and only two of these (15%) were replaced due to complications. Sixteen of 59 patients (27%), 13 years old or older, who arrived with a single lumen RAC already inserted, required an additional catheter during the transplant procedure because of an increased need for intravenous access. From this study, we concluded that patients who arrived for marrow transplantation with a RAC already inserted did not routinely need the catheter replaced. However, it is recommended that double lumen catheters be inserted in adult patients if marrow transplantation is anticipated.