Intravenous access: related problems in oncology.
This article reviews the latest developments in the literature concerning two types of catheter widely used in oncology: Hickman central venous catheters (CVCs) and totally implanted venous ports. It now seems possible to diagnose catheter-related bloodstream infections (CRBI) without removing the device; recent studies showed that paired quantitative blood cultures are the most reliable and convenient method for diagnosis of CRBI. Can CRBI be cured and treated without device removal? A decision-tree/flow-chart resulting from analysis of international data by French International Experts is presented. Futures trends are reviewed: new techniques for prevention, including catheters impregnated with antimicrobials and, antiseptic hubs; flushing and antibiotic lock techniques that can be used both for prevention and treatment.
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Centre Antoine-Lacassagne, 33 Avenue de Valombrose, 06189 Nice Cedex 2, France.
D016470:Bacteremia / Q000188:drug therapy / Q000453:epidemiology / Q000517:prevention & control; D002405:Catheterization, Central Venous / Q000009:adverse effects*; D002408:Catheters, Indwelling / Q000009:adverse effects*; D006801:Humans; D009369:Neoplasms / Q000150:complications* / Q000188:drug therapy; D012307:Risk Factors