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A Protocol to Set Up Needle-Free Connector with Positive Displacement on Central Venous Catheter in Intensive Care Unit
Published on: July 13, 2019
[Infectious complications related to non-tunneled central venous catheters in immunocompromised patients: prospective
A Abdelkefi1, W Achour, L Torjman
1Centre national de greffe de moelle osseuse, Tunis, Tunisie. aabdelkefi@yahoo.fr
Insights
Non-tunneled central venous catheters are safe for immunocompromised patients, including children, in bone marrow units. This study found a low rate of infection (3.1 per 1000 catheter-days) and complications.
Area of Science:
- Medicine
- Infectious Diseases
- Oncology
Background:
- Central venous catheters are essential for immunocompromised patients, particularly those undergoing bone marrow transplantation or chemotherapy.
- Non-tunneled catheters offer a potential alternative to traditional tunneled catheters, but their safety regarding infectious complications needs evaluation.
Purpose of the Study:
- To assess the incidence of infectious complications associated with non-tunneled central venous catheters in immunocompromised patients within a bone marrow unit.
Main Methods:
- A prospective study involving 210 non-tunneled central venous catheter insertions in 139 immunocompromised patients (adults and children) between July 2002 and April 2003.
- Catheters were used for bone marrow transplantation, acute leukemia chemotherapy, and immunosuppressive therapy.
Main Results:
- The average catheterization duration was 33 days, with an infection rate of 3.1 per 1000 catheter-days.
- Coagulase-negative Staphylococci were the most common pathogens (64%).
- Minor complications included pneumothorax (0.9%), arterial puncture (0.4%), and catheter-related thrombosis (0.9%).
Conclusions:
- Non-tunneled central venous catheters represent a safe and viable option for immunocompromised patients, including pediatric populations.
- This technique serves as a practical alternative to Hickman catheters, commonly used in bone marrow transplantation settings.
Objective:
To evaluate infectious complications related to non-tunneled central venous catheter in immunocompromised patients, in a bone marrow unit.
Methods:
From July to April 2002, we inserted 210 non-tunneled central venous catheters in 139 immunocompromised patients (52 F/87 M). The mean age was 26 years (3-56 years). Our study included 33 children aged from 3 to 15 years, on whom 46 catheters were placed. The catheters were placed for the following indications: 145 catheters were used in subjects who received a bone marrow transplantation, 58 catheters were placed in subjects who received chemotherapy for acute leukemia and seven catheters were used in patients who received immunosuppressive therapy.
Results:
The mean duration of catheterization was 33 days (7-114 days). There were 3.1 catheter-related infections per 1000 catheter-days. Coagulase-negative Staphylococci were implicated in 64% of cases. We observed two pneumothorax (0.9%), one arterial puncture (0.4%) and two catheter-related thrombosis (0.9%).
Conclusion:
Non-tunneled catheters in immunocompromised patients (adults and children) is a safe technique, and is an alternative to the Hickman catheters which are most widely used today in patients undergoing bone marrow transplantation.
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