Clinical practices concerning central venous catheters in haematological patients.
OBJECTIVE
Central venous catheters (CVCs) are frequently used in patients with a haematological malignancy in order to administer chemotherapy, stem cell infusions, blood products, medication, parenteral hyperalimentation as well as for blood sampling. Reported complications consist of mechanical complications during the insertion and long-term complications such as CVC-related thrombosis and infections. CVC-related thrombosis and infections are frequently occurring complications and may cause significant morbidity in patients with haematological malignancies. CVC-related infections and thrombosis should not be considered as a result of modern care or fait accompli and must be one of the priority targets of a multidisciplinary approach emphasizing quality-of-care improvement.


METHODS
We conducted a survey among 23 Dutch and Belgian haematological centres to assess the local views and clinical practices concerning central venous catheters in haematological patients.


CONCLUSIONS
The local protocols and policies differ greatly among the centres probably reflecting wide differentiations in practice across Europe. It also shows lack of evidence concerning CVC-related thrombosis and infections which may cause morbidity in haematological patients. Further research has to be stimulated and development of clinical practice guidelines should be promoted.
Boersma
R S
RS
University Hospital Maastricht, Department of Internal Medicine, Subdivision of Haematology, P Debyelaan 25, 6229 HX Maastricht, Netherlands. rs.boersma@mumc.azm.nl <rs.boersma@mumc.azm.nl>
Schouten
H C
HC
D001530:Belgium / Q000453:epidemiology; D002173:Cancer Care Facilities; D055499:Catheter-Related Infections / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D002405:Catheterization, Central Venous / Q000009:adverse effects / Q000379:methods / Q000451:nursing / Q000706:statistics & numerical data; D002408:Catheters, Indwelling / Q000009:adverse effects / Q000706:statistics & numerical data; D002985:Clinical Protocols; D055317:Evidence-Based Practice; D019538:Health Care Surveys; D019337:Hematologic Neoplasms / Q000628:therapy*; D006801:Humans; D015994:Incidence; D017053:Infection Control / Q000379:methods; D008495:Medical Oncology / Q000458:organization & administration*; D009426:Netherlands / Q000453:epidemiology; D016134:Organizational Policy; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D017592:Skin Care / Q000379:methods / Q000451:nursing; D013927:Thrombosis / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control