ECO-SEOM-SEEO safety recommendations guideline for cancer patients receiving intravenous therapy

Abstract

Purpose Cancer patients require implantation of venous access devices to meet their personalized therapeutic needs, which are often complex due to the nature of the medication and the disease status. Therefore, it is essential to have standardized protocols that guarantee the best results in health and patient safety. Methods To learn about the availability of protocols and aspects related to safety in clinical practice and to detect possible opportunities for improvement, a survey has been conducted in various Spanish hospitals, in addition to a review of the evidence regarding the various devices available and complications associated with the administration of chemotherapy. Results As a result of both analyses, the Foundation for Excellence and Quality in Oncology (ECO), the Spanish Society of Medical Oncology (SEOM), and the Spanish Society of Oncology Nursing (SEEO) have developed a catheter selection algorithm based on patient characteristics and treatment to facilitate the clinical decision-making process, as well as some recommendations aimed at ensuring patient safety and rational use of available resources. Conclusions In conclusion, both the venous access catheter selection algorithm and the proposed recommendations aim to respond to the needs revealed in clinical practice and to become an integrable tool in electronic prescription systems to offer homogeneous criteria for action in cancer patients that require venous access, optimizing the use of available health resources with the highest safety and quality of life for the patient.

Ultrasound-Guided Totally Implantable Venous Access: Comparison between Arm and Chest Ports in Solid Organ Cancer Patients

“…(3) Unfortunately, there is no prophylaxis to prevent catheter-related VTE among cancer patients, and anticoagulant administration is recommended for high-risk patients with VTE. (8,13) In our study, there was no statistically significant difference in the incidence of thrombosis between the arm and chest port groups.…”

“…For veins of the upper arm to be punctured, it is generally recommended to use veins with a diameter of 3 mm or more. (8,10) We used basilic or cephalic veins with a diameter of more than 3 mm whenever possible; however, brachial veins were used when the diameter the other veins was less than 2 mm or if pathologies otherwise precluded Thrombosis can be very serious and affect the prognosis of cancer patients. These events are closely related to an increased risk of venous thromboembolism among cancer patients.…”

“…. Especially, its safety has been proven for cancer patients who need chemotherapy, and the use of TIVAPs is recommended in guidelines provided by many cancer-related societies (2,3,7,8). The most used vein for the TIVAPs procedure is the internal jugular vein, and a port is inserted in the upper portion of the anterior chest wall.…”

The state of vascular access teams: Results of a European survey

“…While this does not directly indicate whether the correct device is used at the correct time, this does demonstrate that institutions with a VAT utilise a broader range of devices. Many guidelines and tools outline a broad range of vascular access devices and recommend different devices depending on the situation 22‐25 . As those with a VAT were also more likely to use a tool such as a guideline or algorithm, it is possible that this could improve the selection of the correct device.…”

Standardization and Chemical Characterization of Intravenous Therapy in Adult Patients: A Step Further in Medication Safety

“…It has been proven that vesicant drugs may damage tissues even though their osmolarity and pH values are within a physiological range. Though oncology drugs are well characterized [ 61 ], there is no accepted standard for classifying a noncytotoxic solution or medication as a vesicant, and therefore clinicians should rely on the information provided in the summary of product characteristics, case reports and the published literature. The Nurse Infusion Society published a review of vesicant non-cytotoxic drugs with higher evidence in the literature [ 62 ] that allowed the authors in this project to identify vesicants drugs in Table 2 .…”