Use of tunnelled catheters in haematological malignancy patients with neutropenia.
This prospective study analysed 83 patients (age 45 +/- 17 years) with haematological neoplasms, implanted with 93 tunnelled catheters, who were neutropenic or developed neutropenia during treatment. Catheters were implanted in the right (n = 82) or left (n = 11) jugular vein by the same surgical team using the same technique. They remained in place for 124 +/- 88 days: 29% were removed due to infection; 18% due to treatment termination and 2% due to mechanical problems. Seventeen patients died with catheters in place. At 30, 60, 90, 120 and 200 days mean catheter duration rates were 82%, 75%, 65%, 60% and 35%, respectively, and freedom from catheter removal due to infection was 92%, 88%, 80%, 77% and 67%, respectively. Patient diagnosis and history of previous catheter infection did not increase catheter infection risk, but patients undergoing stem cell transplantation had an increased infection risk. Tunnelled catheters can be used in high-risk patients with neutropenia. Systemic infections can be managed in most patients without catheter removal.
Sariosmanoglu
N
N
Department of Cardiovascular Surgery, Dokuz Eylül University Medical School, Izmir, Turkey.
Uğurlu
B
B
Turgut
N H
NH
Demirkan
F
F
Ozsan
H
H
Ergor
G
G
Gulay
Z
Z
Hazan
E
E
Oto
O
O
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002405:Catheterization, Central Venous / Q000009:adverse effects / Q000295:instrumentation / Q000706:statistics & numerical data; D002408:Catheters, Indwelling / Q000009:adverse effects / Q000706:statistics & numerical data; D002648:Child; D002675:Child, Preschool; D020878:Device Removal; D005260:Female; D019337:Hematologic Neoplasms / Q000150:complications*; D006801:Humans; D007223:Infant; D007239:Infections / Q000209:etiology; D007601:Jugular Veins / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009503:Neutropenia / Q000209:etiology*; D011446:Prospective Studies; D033581:Stem Cell Transplantation; D015996:Survival Rate