CVC complications in hematological patients
Abstract:
Background: The frequency of central venous catheter (CVC) related complications in hematological patients has previously been studied but some uncertainty remains. Therefore, this observational cohort study was designed primarily to investigate mechanical and infectious complications related to CVC insertion in hematological patients and secondarily, to identify factors associated with these complications.
Methods: Documented data on CVC insertions in all adult hematology patients who received a CVC from 2013 to 2019 at a University Hospital in Sweden, were retrospectively collected.
Results: A total of 589 CVC insertions in 387 patients were included. The prevalence of moderate and severe mechanical complications, predominantly comprising grade 2-4 bleeding, was 11%. Pre-procedural coagulopathy, number of needle passes and arterial puncture were all independently associated with grade 2-4 bleeding. The incidence of suspected catheter-related infections (sCRI) was 3.7/1000 catheter days. Higher body-mass index and male gender were independently associated with sCRI.
Conclusions: Patients with hematological malignancies have a high risk of both grade 2-4 bleeding and sCRI after CVC insertion. This underlines the importance of optimizing the conditions at the insertion and also of daily inspections, evaluation of future needs and extra precautions to avoid sCRI in these susceptible patients.
Reference:
Rockholt MM, Thorarinsdottir HR, Lazarevic V, Rundgren M, Kander T. Central Venous Catheter Related Complications in Hematological Patients: An Observational Study. Acta Anaesthesiol Scand. 2021 Dec 14. doi: 10.1111/aas.14020. Epub ahead of print. PMID: 34907524.