Complications associated with peripherally inserted central catheters and Hickman™ in patients with advanced pulmonary hypertension treated with intravenous prostanoids

Hinojosa, Williams; Cruz, Alba; Cruz‐Utrilla, Alejandro; Ropero, María José Cristo; López‐Medrano, Francisco; Gómez, Itzíar; Arribas, Fernando; Escribano, Pilar

doi:10.1016/j.rmed.2021.106649

Cited by 4 publications

(2 citation statements)

References 31 publications

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“…Cancer patients frequently require CVCs for therapy and parenteral nutrition and are at high risk of CVC-related infections due to disease-related and treatment-related immunosuppression ( 5 ). Hickman, peripherally inserted central catheters (PICCs), and implanted venous access ports (PORTs) are three suitable catheterization methods as CVCs for intravenous chemotherapy ( 6 - 8 ). Several trials showed that PORTs were superior to PICCs in cancer patients ( 8 - 11 ).…”

Section: Introductionmentioning

confidence: 99%

Predictors of central line-associated bloodstream infections in cancer patients undergoing chemotherapy through implanted venous access ports: a retrospective, observational study

Chen,

Yamane,

Haruyama

et al. 2023

Transl Cancer Res

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Background Central venous catheters (CVCs) are sometimes superior to peripheral vascular access for chemotherapy. Central line-associated bloodstream infections (CLABSIs) are an important complication of CVCs in chemotherapy. Methods A retrospective, observational study was conducted to investigate patients with implanted venous access ports (PORTs) from July 2010 to June 2021 in a teaching hospital. General conditions of the PORTs, backgrounds, and characteristics of patients were compared between CLABSI cases and uninfected cases to identify predictors of CLABSI. Results A total of 566 patients with PORTs who underwent chemotherapy were enrolled in this study, with CLABSI identified in 41 patients, for a total of 436,597 catheter-days. The median duration of PORT use was 26 vs . 494 days (P<0.001) in the CLABSI and uninfected groups, respectively. There were no significant differences in tumor classification, staging, white blood cell (WBC) count, neutrophil proportion, lymphocyte proportion, albumin, C-reactive protein (CRP), and performance status between the CLABSI and uninfected groups. Multivariable analysis showed that antibiotic usage within the previous week, total protein (TP), and immediate PORT use were independently associated with CLABSI, and their odds ratios (ORs) were 4.89 [95% confidence interval (CI): 1.67, 14.35], 1.95 (95% CI: 1.14, 3.53), and 3.13 (95% CI: 1.18, 8.30), respectively. The area under the curve (AUC) of the receiver-operating characteristic curve for TP was 0.63, and the cutoff value was 5.9 g/dL. Conclusions PORT implantation should be avoided in patients who had antibiotic treatment episodes within 1 week, especially for those with low serum TP levels.

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Section: Introductionmentioning

confidence: 99%

Predictors of central line-associated bloodstream infections in cancer patients undergoing chemotherapy through implanted venous access ports: a retrospective, observational study

Chen,

Yamane,

Haruyama

et al. 2023

Transl Cancer Res

View full text Add to dashboard Cite

show abstract

“…Cancer patients frequently require CVCs for therapy and parenteral nutrition and are at high risk of central venous catheter-related infections (CRIs) due to disease-related and treatment-related immunosuppression [4]. Hickman, peripherally inserted central catheters (PICCs), and implantable venous ports (PORTs) are three suitable catheterization methods as CVCs for intravenous chemotherapy [5][6][7]. Based on clinical symptoms and laboratory ndings, localized infections of CVCs such as exit-site infections, tunnel infections, and port-pocket infections are distinguished from central line-associated bloodstream infections (CLABSIs) or catheter-related blood stream infections (CRBSIs).…”

Section: Introductionmentioning

confidence: 99%

Predictors of central line-associated bloodstream infections in cancer patients undergoing chemotherapy through implanted venous access ports: a cross-sectional, observational study

Chen

Yamane

Kazahari

et al. 2022

Preprint

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Background: Central vascular catheters (CVCs) are superior to peripheral vascular access in chemotherapy. Central line-associated bloodstream infections (CLABSIs) are an important complication of CVCs in chemotherapy.Methods: A cross-sectional, observational study was conducted to investigate patients with implanted venous access ports (PORTs) from July 2010 to June 2021 in a teaching hospital. General conditions of the PORTs, backgrounds, and characteristics of patients were compared between CLABSI and uninfected patients to identify predictors of CLABSI.Results: A total of 566 patients with PORTs who underwent chemotherapy were enrolled in this study, with CLABSI identified in 41 patients, for a total of 436,597 catheter-days. The median duration of PORT use was 26 days vs 494 days (p < 0.001) in the CLABSI and uninfected groups, respectively. There were no significant differences in tumor classification, staging, white blood cell (WBC) count, neutrophil proportion, lymphocyte proportion, albumin, C-reactive protein (CRP), and performance status between the CLABSI and uninfected groups. Multivariable analysis showed that total protein, antibiotic usage before one week, and immediate use of PORT were independently associated with CLABSI, and their odds ratios (ORs) were 1.84 (95% confidence interval (CI) 1.08, 3.13), 3.34 (95%CI 1.20, 9.32), and 2.37 (95%CI 1.01, 5.54), respectively.Conclusions: PORT implantation should be avoided in patients who have received antibiotic treatment or had antibiotic treatment episodes within one week, especially for those with low serum total protein levels.

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Dual prostacyclin infusions: A case report of a patient symptom–driven transition from high-dose intravenous epoprostenol to subcutaneous treprostinil for the treatment of pulmonary arterial hypertension

Stone,

Kuebel,

Guido

et al. 2024

American Journal of Health-System Pharmacy

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Disclaimer In an effort to expedite the publication of articles, AJHP is posting manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time. Purpose A case of successful transition from high-dose epoprostenol to high-dose subcutaneous treprostinil for treatment of pulmonary arterial hypertension (PAH) is reported. Summary PAH is a chronically progressive disease characterized by pulmonary artery luminal narrowing that causes increased pulmonary artery pressures leading to right ventricular failure. Parenteral prostacyclin analogues, such as epoprostenol and treprostinil, are direct vasodilators and are cornerstones of therapy for patients with severe disease that have been proven to reduce mortality and increase exercise tolerance. These agents must be administered continuously via intravenous or subcutaneous devices and are high-risk medications due to their potent vasodilatory actions. Chronic use of these medications requires constant attention from both providers and patients because of potential complications including central venous catheter infection, thromboembolism, therapy interruptions, and other undesirable consequences. This case report describes management of a 35-year-old male patient on high-dose outpatient intravenous epoprostenol (101 ng/kg/min; dosing weight, 47 kg) for treatment of PAH who was admitted to the hospital with a malfunctioning central venous catheter. Surrounding manipulation of the central catheter, the patient experienced an ischemic stroke that led to cognitive disability resulting in a lack of ability to manage his previously used home infusion device. The patient was successfully transitioned from intravenous epoprostenol to subcutaneous treprostinil (discharge dose, 200 ng/kg/min) over 5 days by infusing both medications simultaneously and adjusting doses based upon patient-reported symptoms. Conclusion This successful transition from high-dose epoprostenol to high-dose subcutaneous treprostinil demonstrates the importance in considering patient-specific factors during high-risk medication transitions, the value of a patient-directed flexible prostacyclin transition plan, and the benefit of institutional training and education in ensuring the safe use of parenteral prostacyclin analogues.

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Complications associated with peripherally inserted central catheters and Hickman™ in patients with advanced pulmonary hypertension treated with intravenous prostanoids

Cited by 4 publications

References 31 publications

Predictors of central line-associated bloodstream infections in cancer patients undergoing chemotherapy through implanted venous access ports: a retrospective, observational study

Predictors of central line-associated bloodstream infections in cancer patients undergoing chemotherapy through implanted venous access ports: a retrospective, observational study

Predictors of central line-associated bloodstream infections in cancer patients undergoing chemotherapy through implanted venous access ports: a cross-sectional, observational study

Dual prostacyclin infusions: A case report of a patient symptom–driven transition from high-dose intravenous epoprostenol to subcutaneous treprostinil for the treatment of pulmonary arterial hypertension

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