Patterns of use of vascular access devices in patients undergoing hematopoietic stem cell transplantation: Results of an international survey
Date
2007Abstract
Introduction 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.
Materials and 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.
Discussion 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