Scheduled removal of central venous catheters (CVC) to prevent CVC-related bloodstream infections in patients with hematological disease or autologous stem cell transplantation: a registry-based randomized simulation-study.

Autor: Panse J; Department of Oncology, Hematology, Hemostaseology and Stem Cell Transplantation, University Hospital RWTH Aachen, Aachen, Germany.; Center for Integrated Oncology (CIO), Aachen, Bonn, Cologne, Düsseldorf (ABCD), Germany., Tölle D; Department of Hematology, Medical Oncology, and Pneumology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany., Fiegle E; Department of Oncology, Hematology, Hemostaseology and Stem Cell Transplantation, University Hospital RWTH Aachen, Aachen, Germany.; Center for Integrated Oncology (CIO), Aachen, Bonn, Cologne, Düsseldorf (ABCD), Germany., Naendrup JH; Center for Integrated Oncology (CIO), Aachen, Bonn, Cologne, Düsseldorf (ABCD), Germany.; Department of Internal Medicine I, University Hospital of Cologne, Cologne, Germany., Schmidt-Hieber M; Clinic of Hematology, Oncology, and Pneumology, Carl-Thiem-Hospital Cottbus, Cottbus, Germany., Böll B; Center for Integrated Oncology (CIO), Aachen, Bonn, Cologne, Düsseldorf (ABCD), Germany.; Department of Internal Medicine I, University Hospital of Cologne, Cologne, Germany., Hentrich M; Department of Hematology and Oncology, Red Cross Hospital Munich, Munich, Germany., Teschner D; Department of Hematology, Medical Oncology, and Pneumology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany.; Department of Internal Medicine II, University Hospital Würzburg, Würzburg, Germany., Schalk E; Department of Hematology and Oncology, Medical Center, Otto-von-Guericke University Magdeburg, Leipziger Str. 44, 39120, Magdeburg, Germany. enrico.schalk@med.ovgu.de.
Jazyk: angličtina
Zdroj: Annals of hematology [Ann Hematol] 2022 Oct; Vol. 101 (10), pp. 2317-2324. Date of Electronic Publication: 2022 Aug 17.
DOI: 10.1007/s00277-022-04958-w
Abstrakt: Although not generally recommended, scheduled central venous catheter (CVC) removal is sometimes carried out in order to reduce the CVC-related bloodstream infection (CRBSI) incidence. We conducted a simulation for scheduled CVC removal within the multicenter CRBSI registry (SECRECY). Non-tunneled jugular and subclavian CVC in patients with hematological disease or with germ cell tumors (including patients receiving autologous stem cell transplantation [SCT]) were included. Cases were randomized in a 1:1:1:1 ratio to either a simulated, scheduled CVC removal after 7, 14, and 21 days, or to non-simulated, unscheduled CVC removal (control group). The primary endpoint was definitive CRBSI incidence for a scheduled CVC removal after 14 days (dCRBSI-D14 rmv ). Among other, secondary endpoints were definite CRBSI incidence for a scheduled removal after 7 days (dCRBSI-D7 rmv ) and 21 days (dCRBSI-D21 rmv ). Data on 2984 CVC were included. Patients' median age was 59 (range 16-95) years, 58.8% being male. The vast majority (98.4%) were patients with hematological malignancies. Jugular veins were the main insertion site (93.2%). dCRBSI-D14 rmv was 3.10/1000 CVC days as compared to 4.15/1000 CVC days in the control group (p = 0.23). There was a significant difference between dCRBSI-D7 rmv (0.86/1000 CVC days) and controls (p < 0.001), but not between dCRBSI-D21 rmv (4.10/1000 CVC days) and controls (p = 0.96). Our data suggest that in patients with hematological diseases or autologous SCT recipients scheduled CVC removal after 14 days does not result in a lower CRBSI incidence compared to unscheduled removal.Trial registration: DRKS00006551, 2014/09/29, retrospectively registered.
(© 2022. The Author(s).)
Databáze: MEDLINE
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