title: Patterns of use of vascular access devices in patients undergoing hematopoietic stem cell transplantation: results of an international survey.
abstract: BACKGROUND
  There is limited information regarding of use of vascular access devices (VAD) in patients undergoing hematopoietic stem cell transplantation (HSCT). The frequent use of VAD in HSCT and its potential to cause morbidity requires understanding of the general use of VAD in HSCT.
  
  
  METHODS
  A World Wide Web-based 19-item questionnaire was designed to determine the patterns of use of VAD in patients undergoing HSCT. The questionnaire was sent via electronic mail to the directors of HSCT programs throughout the world.
  
  
  RESULTS
  Of the 445 centers surveyed, 163 centers replied for a response rate of 37%. The most commonly used catheter for autologous peripheral blood stem cell (PBSC) harvest is the dual-lumen plasmapheresis/hemodialysis (62%). Of the institutions, 58% utilize the same catheter used for PBSC harvest to provide vascular access support during the transplant. Catheter-related blood stream infection (36%) and withdrawal occlusion (31%) were the most frequently encountered complications of VAD. Of the centers, 65% have established criteria for VAD removal when infection is suspected and 48% when occlusion is suspected.
  
  
  CONCLUSIONS
  Our study demonstrated that there are similarities in the utilization of VAD but also wide differences in the standard procedures for the insertion and care of VAD in the transplant setting. More comprehensive studies are needed to assess the use of central venous catheters in transplant recipients. Important areas for future research include the impact of VAD utilization on the quality of life of transplant recipients and the final consequences of VAD complications.
authors.affiliation: Division of Hematology, Department of Medicine, Bone Marrow Transplant Unit, Audie L. Murphy Memorial Veterans Hospital, San Antonio, TX 78229-3900, USA. toro@uthscsa.edu
authors.forename: Juan J
authors.initials: JJ
authors.lastname: Toro
authors.forename: Manuel
authors.initials: M
authors.lastname: Morales
authors.forename: Fausto
authors.initials: F
authors.lastname: Loberiza
authors.forename: Jose L
authors.initials: JL
authors.lastname: Ochoa-Bayona
authors.forename: Cesar O
authors.initials: CO
authors.lastname: Freytes
mesh_terms: D002405:Catheterization, Central Venous; D002408:Catheters, Indwelling; D019538:Health Care Surveys; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods*; D006801:Humans; D038622:Internationality; D020407:Internet; D011795:Surveys and Questionnaires; D014180:Transplantation