Prevencija infekcija povezanih s centralnim venskim kateterima u hematologiji

Autor: Frigan, Katarina
Přispěvatelé: Meštrović, Tomislav
Jazyk: chorvatština
Rok vydání: 2020
Předmět:
Popis: Hemato-onkološke bolesti kao kronične bolesti karakterizira izmjena između perioda remisije i relapsa, a citostatska kemoterapija najčešći je način liječenja i kontroliranja bolesti. Klinička slika hematološko-onkoloških bolesti ovisi o vrsti bolesti, stoga se može razlikovati ona kod limfoma, leukemije, mijeloma, anemije, bolesti srpastih stanica i hemofilije. Citostatsko liječenje je dugotrajno, a intravenozna primjena lijekova se najčešće primjenjuje putem centralnih venskih katetera. Postavljanjem centralnog venskog katetera se pristupa centralnoj cirkulaciji budući se kateter postavlja u jednu od velikih krvnih žila, što predstavlja veliki rizik za nastanak jedne od najčešćih komplikacija, a to je infekcija. Na tržištu postoji nekoliko vrsta centralnih katetera, a koji od njih će se postaviti bolesniku, ovisi o vrsti i trajanju terapije. Izrađuju se od različitih materijala, ali se najčešće koriste oni od poliuretana i silikona, a mogu imati 1 do 5 lumena putem kojih se lijekovi i infuzijske otopine mogu primjenjivati istovremeno. Infekcije krvotoka povezane s centralnim venskim kateterima važan su uzrok bolničkih infekcija povezanih s povećanim morbiditetom, smrtnošću i troškovima. Posljedice ovise o povezanim organizmima, temeljnim predmorbidnim uvjetima, pravodobnosti i adekvatnosti primjenjenog tretmana, odnosno intervencija. Rizik za nastanak i razvoj infekcije povezane s centralnim venskim kateterom u hematologiji je značajno veći budući je većina bolesnika imunokompromitirana, što ih čini značajno podložnijima u odnosu na ostale bolesnike. Cilj djelotvornog preventivnog programa trebao bi biti uklanjanje infekcija krvotoka povezanih s centralnim venskim kateterom iz svih područja skrbi o bolesnicima, što predstavlja veliki izazov. Hemato-oncological diseases as chronic diseases are characterized by changes between the period of remission and relapse, and cytostatic chemotherapy is the most common way of treating and controlling the disease. The clinical presentation of hematological-oncological diseases depends on the type of disease, so it can differ in lymphoma, leukemia, myeloma, anemia, sickle cell disease and hemophilia. Cytostatic treatment is long-term, and intravenous drug administration is most commonly administered via central venous catheters. By placing a central venous catheter, the central circulation is accessed, since the catheter is placed in one of the large blood vessels, which represents a great risk for the occurrence of one of the most common complications, which is infection. There are several types of central catheters on the market, and which of them will be placed on the patient depends on the type and duration of therapy. They are made of different materials, but those made of polyurethane and silicone are most commonly used, and can have 1 to 5 lumens through which drugs and infusion solutions can be administered simultaneously. Bloodstream infections associated with central venous catheters are an important cause of nosocomial infections associated with increased morbidity, mortality, and cost. The consequences depend on the associated organisms, the underlying premorbid conditions, the timeliness and adequacy of the treatment or intervention applied. The risk of developing and developing an infection associated with a central venous catheter in hematology is significantly higher since most patients are immunocompromised, making them significantly more susceptible than other patients. The goal of an effective prevention program should be to eliminate circulatory infections associated with the central venous catheter from all areas of patient care, which is a major challenge.
Databáze: OpenAIRE
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