Volume 26, Issue 23-24 pp. 4726-4733

ORIGINAL ARTICLE

Complications of peripherally inserted central catheters in advanced cancer patients undergoing combined radiotherapy and chemotherapy

Jun Xie RN, BSN, CPN,

Jun Xie RN, BSN, CPN

Nurse in Charge

Department of Hematology, Wuxi People's Hospital Affiliated to Nanjing Medical University, Wuxi, Jiangsu, China

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Linjie Xu RN, BSN, CPN,

Linjie Xu RN, BSN, CPN

Nurse in Charge

Department of Hematology, Wuxi People's Hospital Affiliated to Nanjing Medical University, Wuxi, Jiangsu, China

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Xiaomin Xu RN, BSN, CPN,

Corresponding Author

Xiaomin Xu RN, BSN, CPN

Nurse in Charge

[email protected]

Department of Hematology, Wuxi People's Hospital Affiliated to Nanjing Medical University, Wuxi, Jiangsu, China

Correspondence

Xiaomin Xu and Yunjuan Huang, Department of Hematology, Wuxi People's Hospital Affiliated to Nanjing Medical University, Wuxi, Jiangsu, China.

Emails: [email protected], [email protected]

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Yunjuan Huang RN, BSN, CPN,

Corresponding Author

Yunjuan Huang RN, BSN, CPN

Chief Superintendent Nurse

[email protected]

orcid.org/0000-0001-6216-8261

Department of Hematology, Wuxi People's Hospital Affiliated to Nanjing Medical University, Wuxi, Jiangsu, China

Correspondence

Xiaomin Xu and Yunjuan Huang, Department of Hematology, Wuxi People's Hospital Affiliated to Nanjing Medical University, Wuxi, Jiangsu, China.

Emails: [email protected], [email protected]

Search for more papers by this author

Jun Xie RN, BSN, CPN,

Jun Xie RN, BSN, CPN

Nurse in Charge

Department of Hematology, Wuxi People's Hospital Affiliated to Nanjing Medical University, Wuxi, Jiangsu, China

Search for more papers by this author

Linjie Xu RN, BSN, CPN,

Linjie Xu RN, BSN, CPN

Nurse in Charge

Department of Hematology, Wuxi People's Hospital Affiliated to Nanjing Medical University, Wuxi, Jiangsu, China

Search for more papers by this author

Xiaomin Xu RN, BSN, CPN,

Corresponding Author

Xiaomin Xu RN, BSN, CPN

Nurse in Charge

[email protected]

Department of Hematology, Wuxi People's Hospital Affiliated to Nanjing Medical University, Wuxi, Jiangsu, China

Correspondence

Xiaomin Xu and Yunjuan Huang, Department of Hematology, Wuxi People's Hospital Affiliated to Nanjing Medical University, Wuxi, Jiangsu, China.

Emails: [email protected], [email protected]

Search for more papers by this author

Yunjuan Huang RN, BSN, CPN,

Corresponding Author

Yunjuan Huang RN, BSN, CPN

Chief Superintendent Nurse

[email protected]

orcid.org/0000-0001-6216-8261

Department of Hematology, Wuxi People's Hospital Affiliated to Nanjing Medical University, Wuxi, Jiangsu, China

Correspondence

Xiaomin Xu and Yunjuan Huang, Department of Hematology, Wuxi People's Hospital Affiliated to Nanjing Medical University, Wuxi, Jiangsu, China.

Emails: [email protected], [email protected]

Search for more papers by this author

First published: 23 March 2017

https://doi.org/10.1111/jocn.13825

Citations: 16

Funding information

This work was funded by Wuxi Medical Controlling Center (YGZXH1313)

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Abstract

Aims and objectives

To identify whether patients with advanced cancers were at high risk of peripherall"y inserted central catheter-related complications when treated with concurrent chemo-radiotherapy.

Background

Peripherally inserted central catheters are widely used in chemotherapy. However, catheter usage may elevate the risks of infections and thrombosis. It is important to identify the patients with high risk of peripherally inserted central catheter-related complications. To date, little is known about peripherally inserted central catheter-related complications in patients with advanced cancers and receiving concurrent chemo-radiotherapy.

Design

Five hundred and sixty-nine cancer patients with advanced cancers and treated by chemo-radiotherapy were analysed in the study. The incidences of peripherally inserted central catheter-related complications were investigated.

Methods

Univariable and multivariable logistic regression analyses were employed for identification of risk factors.

Results

Eighty-six (15.1%) patients exhibited peripherally inserted central catheter-related infectious complications, of which 6.3% were local infection, 3.9% were catheter-related bloodstream infection and 4.9% were exit-site infection. Sixty-five (11.4%) developed symptomatic peripherally inserted central catheter-related thrombosis, and 52 (9.1%) were suffering from phlebitis. The overall complication rate was 53.1%. The univariable logistic regression and multivariate analysis showed that comorbidity (OR 1.51, p = .0148) and body mass index (OR 1.46, p = .0157), and duration of radio-chemotherapy (OR 1.4733, p = .0049) were significantly associated with peripherally inserted central catheter-related complications. Patients with peripherally inserted central catheter-related complications showed lower 5-year survival rate than those without peripherally inserted central catheter-related complications.

Conclusions

Identification of risk factors for peripherally inserted central catheter-related complications in patients with advanced cancer before catheter usage may play an important role in improvement of the prognosis.

Relevance to clinical practice

Doctors need to be aware of the risk of peripherally inserted central catheter-related complications in patients with advanced cancers.

REFERENCES

Al Raiy, B., Fakih, M. G., Bryan-Nomides, N., Hopfner, D., Riegel, E., Nenninger, T., … Khatib, R. (2010). Peripherally inserted central venous catheters in the acute care setting: A safe alternative to high-risk short-term central venous catheters. American Journal of Infection Control, 38, 149–153.
10.1016/j.ajic.2009.06.008
PubMed Web of Science® Google Scholar
Amerasekera, S. S., Jones, C. M., Patel, R., & Cleasby, M. J. (2009). Imaging of the complications of peripherally inserted central venous catheters. Clinical Radiology, 64, 832–840.
10.1016/j.crad.2009.02.021
CAS PubMed Web of Science® Google Scholar
Aw, A., Carrier, M., Koczerginski, J., McDiarmid, S., & Tay, J. (2012). Incidence and predictive factors of symptomatic thrombosis related to peripherally inserted central catheters in chemotherapy patients. Thrombosis Research, 130, 323–326.
10.1016/j.thromres.2012.02.048
CAS PubMed Web of Science® Google Scholar
Bar-Ad, V., Leiby, B., Witek, M., Xiao, Y., Cui, Y., Dai, Y., … Werner-Wasik, M. (2014). Treatment-related acute esophagitis for patients with locoregionally advanced non-small cell lung cancer treated with involved-field radiotherapy and concurrent chemotherapy. American Journal of Clinical Oncology, 37, 433–437.
10.1097/COC.0b013e31827de7a2
CAS PubMed Web of Science® Google Scholar
Bellesi, S., Chiusolo, P., De Pascale, G., Pittiruti, M., Scoppettuolo, G., Metafuni, E., … Sica, S. (2013). Peripherally inserted central catheters (PICCs) in the management of oncohematological patients submitted to autologous stem cell transplantation. Supportive Care in Cancer, 21, 531–535.
10.1007/s00520-012-1554-0
PubMed Web of Science® Google Scholar
Botella-Carretero, J. I., Carrero, C., Guerra, E., Valbuena, B., Arrieta, F., Calanas, A., … Vazquez, C. (2013). Role of peripherally inserted central catheters in home parenteral nutrition: A 5-year prospective study. JPEN. Journal of Parenteral and Enteral Nutrition, 37, 544–549.
10.1177/0148607112457422
PubMed Web of Science® Google Scholar
Bouwman, F., Smits, A., Lopes, A., Das, N., Pollard, A., Massuger, L., … Galaal, K. (2015). The impact of BMI on surgical complications and outcomes in endometrial cancer surgery—An institutional study and systematic review of the literature. Gynecologic Oncology, 139, 369–376.
10.1016/j.ygyno.2015.09.020
PubMed Web of Science® Google Scholar
Chemaly, R. F., de Parres, J. B., Rehm, S. J., Adal, K. A., Lisgaris, M. V., Katz-Scott, D. S., … Longworth, D. L. (2002). Venous thrombosis associated with peripherally inserted central catheters: A retrospective analysis of the Cleveland Clinic experience. Clinical Infectious Diseases, 34, 1179–1183.
10.1086/339808
PubMed Web of Science® Google Scholar
Chen, Y. L., Liu, Y. Q., Tang, D. H., & Chu, C. N. (2008). [Comparative study of different chemotherapy approaches for advanced epithelial ovarian cancer]. Zhonghua Fu Chan Ke Za Zhi, 43, 110–114.
PubMed Web of Science® Google Scholar
Cheong, K., Perry, D., Karapetis, C., & Koczwara, B. (2004). High rate of complications associated with peripherally inserted central venous catheters in patients with solid tumours. Internal Medicine Journal, 34, 234–238.
10.1111/j.1444-0903.2004.00447.x
CAS PubMed Web of Science® Google Scholar
Chopra, V., Anand, S., Hickner, A., Buist, M., Rogers, M. A., Saint, S., & Flanders, S. A. (2013). Risk of venous thromboembolism associated with peripherally inserted central catheters: A systematic review and meta-analysis. Lancet, 382, 311–325.
10.1016/S0140-6736(13)60592-9
PubMed Web of Science® Google Scholar
Chopra, V., Kuhn, L., Ratz, D., Lee, A., & Krein, S. (2014). Peripherally inserted central catheter-related deep vein thrombosis: Contemporary patterns and predictors: Reply. Journal of Thrombosis and Haemostasis, 12, 1944–1947.
10.1111/jth.12721
CAS PubMed Web of Science® Google Scholar
Chopra, V., O'Horo, J. C., Rogers, M. A., Maki, D. G., & Safdar, N. (2013). The risk of bloodstream infection associated with peripherally inserted central catheters compared with central venous catheters in adults: A systematic review and meta-analysis. Infection Control and Hospital Epidemiology, 34, 908–918.
10.1086/671737
PubMed Web of Science® Google Scholar
Chopra, V., Ratz, D., Kuhn, L., Lopus, T., Chenoweth, C., & Krein, S. (2014). PICC-associated bloodstream infections: Prevalence, patterns, and predictors. American Journal of Medicine, 127, 319–328.
10.1016/j.amjmed.2014.01.001
PubMed Web of Science® Google Scholar
Cortelezzia, A., Fracchiolla, N. S., Maisonneuve, P., Moia, M., Luchesini, C., Ranzi, M. L., … Lambertenghi-Deliliers, G. (2003). Central venous catheter-related complications in patients with hematological malignancies: A retrospective analysis of risk factors and prophylactic measures. Leukaemia & Lymphoma, 44, 1495–1501.
10.1080/1042819031000103980
CAS PubMed Web of Science® Google Scholar
Cotogni, P., Barbero, C., Garrino, C., Degiorgis, C., Mussa, B., De Francesco, A., & Pittiruti, M. (2015). Peripherally inserted central catheters in non-hospitalized cancer patients: 5-year results of a prospective study. Supportive Care in Cancer, 23, 403–409.
10.1007/s00520-014-2387-9
PubMed Web of Science® Google Scholar
DeFoe, S. G., Kabolizadeh, P., Heron, D. E., & Beriwal, S. (2013). Dosimetric parameters predictive of acute gastrointestinal toxicity in patients with anal carcinoma treated with concurrent chemotherapy and intensity-modulated radiation therapy. Oncology, 85, 1–7.
10.1159/000348387
CAS PubMed Web of Science® Google Scholar
Del Principe, M. I., Buccisano, F., Maurillo, L., Venditti, D., Cefalo, M., Sarlo, C., … Venditti, A. (2013). Infections increase the risk of central venous catheter-related thrombosis in adult acute myeloid leukemia. Thrombosis Research, 132, 511–514.
10.1016/j.thromres.2013.08.007
CAS PubMed Web of Science® Google Scholar
DeLegge, M. H., Borak, G., & Moore, N. (2005). Central venous access in the home parenteral nutrition population-you PICC. JPEN. Journal of Parenteral and Enteral Nutrition, 29, 425–428.
10.1177/0148607105029006425
PubMed Web of Science® Google Scholar
Dinges, E., Felderman, N., McGuire, S., Gross, B., Bhatia, S., Mott, S., … Wang, D. (2015). Bone marrow sparing in intensity modulated proton therapy for cervical cancer: Efficacy and robustness under range and setup uncertainties. Radiotherapy and Oncology, 115, 373–378.
10.1016/j.radonc.2015.05.005
PubMed Web of Science® Google Scholar
Dua, A., Desai, S. S., Nodel, A., & Heller, J. A. (2015). The impact of body mass index on lower extremity duplex ultrasonography for deep vein thrombosis diagnosis. Annals of Vascular Surgery, 29, 1136–1140.
10.1016/j.avsg.2015.03.038
PubMed Web of Science® Google Scholar
Fallouh, N., McGuirk, H. M., Flanders, S. A., & Chopra, V. (2015). Peripherally inserted central catheter-associated deep vein thrombosis: A narrative review. American Journal of Medicine, 128, 722–738.
10.1016/j.amjmed.2015.01.027
PubMed Web of Science® Google Scholar
Fukuda, S., Nakajima, K., Miyazaki, Y., Takahashi, T., Kurokawa, Y., Yamasaki, M., … Doki, Y. (2015). Use of double-lumen peripherally inserted central catheters for safer perioperative management of esophageal cancer patients. The Journal of Vascular Access, 16, 338–343.
10.5301/jva.5000382
PubMed Web of Science® Google Scholar
Gunst, M., Matsushima, K., Vanek, S., Gunst, R., Shafi, S., & Frankel, H. (2011). Peripherally inserted central catheters may lower the incidence of catheter-related blood stream infections in patients in surgical intensive care units. Surgical Infections (Larchmt), 12, 279–282.
10.1089/sur.2008.058
PubMed Web of Science® Google Scholar
Harnage, S. (2012). Seven years of zero central-line-associated bloodstream infections. British Journal of Nursing, 21, S6, S8, S10–12.
10.12968/bjon.2012.21.Sup21.S6
PubMed Google Scholar
Hartmann, O., Benhamou, E., Beaujean, F., Kalifa, C., Lejars, O., Patte, C., … Deville, A. (1987). Repeated high-dose chemotherapy followed by purged autologous bone marrow transplantation as consolidation therapy in metastatic neuroblastoma. Journal of Clinical Oncology, 5, 1205–1211.
10.1200/JCO.1987.5.8.1205
CAS PubMed Web of Science® Google Scholar
Hingorani, A., Ascher, E., Markevich, N., Yorkovich, W., Schutzer, R., Mutyala, M., … Jacob, T. (2005). Risk factors for mortality in patients with upper extremity and internal jugular deep venous thrombosis. Journal of Vascular Surgery, 41, 476–478.
10.1016/j.jvs.2004.12.038
PubMed Web of Science® Google Scholar
Kim, H. J., Yun, J., Kim, K. H., Kim, S. H., Lee, S. C., Bae, S. B., … Hong, D. S. (2010). Safety and effectiveness of central venous catheterization in patients with cancer: Prospective observational study. Journal of Korean Medical Science, 25, 1748–1753.
10.3346/jkms.2010.25.12.1748
PubMed Web of Science® Google Scholar
Liu, Y., Gao, Y., Wei, L., Chen, W., Ma, X., & Song, L. (2015). Peripherally inserted central catheter thrombosis incidence and risk factors in cancer patients: A double-center prospective investigation. Therapeutics and Clinical Risk Management, 11, 153–160.
PubMed Web of Science® Google Scholar
Loughran, S. C., & Borzatta, M. (1995). Peripherally inserted central catheters: A report of 2506 catheter days. JPEN. Journal of Parenteral and Enteral Nutrition, 19, 133–136.
10.1177/0148607195019002133
CAS PubMed Web of Science® Google Scholar
Mermel, L. A., Allon, M., Bouza, E., Craven, D. E., Flynn, P., O'Grady, N. P., … Warren, D. K. (2009). Clinical practice guidelines for the diagnosis and management of intravascular catheter-related infection: 2009 Update by the Infectious Diseases Society of America. Clinical Infectious Diseases, 49, 1–45.
10.1086/599376
CAS PubMed Web of Science® Google Scholar
Miller, D. L., & O'Grady, N. P. (2012). Guidelines for the prevention of intravascular catheter-related infections: Recommendations relevant to interventional radiology for venous catheter placement and maintenance. Journal of Vascular and Interventional Radiology, 23, 997–1007.
10.1016/j.jvir.2012.04.023
PubMed Web of Science® Google Scholar
Moran, J., Colbert, C. Y., Song, J., Mathews, J., Arroliga, A. C., Varghees, S., … Reddy, S. (2014). Screening for novel risk factors related to peripherally inserted central catheter-associated complications. Journal of Hospital Medicine, 9, 481–489.
10.1002/jhm.2207
CAS PubMed Web of Science® Google Scholar
Morano, S. G., Latagliata, R., Girmenia, C., Massaro, F., Berneschi, P., Guerriero, A., … Foa, R. (2015). Catheter-associated bloodstream infections and thrombotic risk in hematologic patients with peripherally inserted central catheters (PICC). Supportive Care in Cancer, 23, 3289–3295.
10.1007/s00520-015-2740-7
PubMed Web of Science® Google Scholar
Moureau, N., Poole, S., Murdock, M. A., Gray, S. M., & Semba, C. P. (2002). Central venous catheters in home infusion care: Outcomes analysis in 50,470 patients. Journal of Vascular and Interventional Radiology, 13, 1009–1016.
10.1016/S1051-0443(07)61865-X
PubMed Web of Science® Google Scholar
Pan, L., Zhao, Q., & Yang, X. (2014). Risk factors for venous thrombosis associated with peripherally inserted central venous catheters. International Journal of Clinical and Experimental Medicine, 7, 5814–5819.
PubMed Web of Science® Google Scholar
Patel, G. S., Jain, K., Kumar, R., Strickland, A. H., Pellegrini, L., Slavotinek, J., … Karapetis, C. S. (2014). Comparison of peripherally inserted central venous catheters (PICC) versus subcutaneously implanted port-chamber catheters by complication and cost for patients receiving chemotherapy for non-haematological malignancies. Supportive Care in Cancer, 22, 121–128.
10.1007/s00520-013-1941-1
CAS PubMed Web of Science® Google Scholar
Pittiruti, M., Hamilton, H., Biffi, R., MacFie, J., & Pertkiewicz, M. (2009). ESPEN Guidelines on Parenteral Nutrition: Central venous catheters (access, care, diagnosis and therapy of complications). Clinical Nutrition, 28, 365–377.
10.1016/j.clnu.2009.03.015
PubMed Web of Science® Google Scholar
Sakai, T., Kohda, K., Konuma, Y., Hiraoka, Y., Ichikawa, Y., Ono, K., … Kato, J. (2014). A role for peripherally inserted central venous catheters in the prevention of catheter-related blood stream infections in patients with hematological malignancies. International Journal of Hematology, 100, 592–598.
10.1007/s12185-014-1677-9
PubMed Web of Science® Google Scholar
Smith, R. K., Broach, R. B., Hedrick, T. L., Mahmoud, N. N., & Paulson, E. C. (2014). Impact of BMI on postoperative outcomes in patients undergoing proctectomy for rectal cancer: A national surgical quality improvement program analysis. Diseases of the Colon and Rectum, 57, 687–693.
10.1097/DCR.0000000000000097
PubMed Web of Science® Google Scholar
Yamada, R., Morita, T., Yashiro, E., Otani, H., Amano, K., Tei, Y., & Inoue, S. (2010). Patient-reported usefulness of peripherally inserted central venous catheters in terminally ill cancer patients. Journal of Pain and Symptom Management, 40, 60–66.
10.1016/j.jpainsymman.2009.11.327
PubMed Web of Science® Google Scholar
Yap, Y. S., Karapetis, C., Lerose, S., Iyer, S., & Koczwara, B. (2006). Reducing the risk of peripherally inserted central catheter line complications in the oncology setting. European Journal of Cancer Care (England), 15, 342–347.
10.1111/j.1365-2354.2006.00664.x
CAS PubMed Web of Science® Google Scholar
Yi, X. L., Chen, J., Li, J., Feng, L., Wang, Y., Zhu, J. A., … Hu, B. (2014). Risk factors associated with PICC-related upper extremity venous thrombosis in cancer patients. Journal of Clinical Nursing, 23, 837–843.
10.1111/jocn.12227
PubMed Web of Science® Google Scholar
Yousif, A., Chaftari, A. M., Michael, M., Jordan, M., Al Hamal, Z., Hussain, A., … Raad, I. (2016). The influence of using antibiotic-coated peripherally inserted central catheters on decreasing the risk of central line-associated bloodstream infections. American Journal of Infection Control, 44, 1037–1040.
10.1016/j.ajic.2015.12.015
PubMed Web of Science® Google Scholar

Citing Literature

Volume26, Issue23-24

December 2017

Pages 4726-4733

Complications of peripherally inserted central catheters in advanced cancer patients undergoing combined radiotherapy and chemotherapy

Abstract

Aims and objectives

Background

Design

Methods

Results

Conclusions

Relevance to clinical practice

REFERENCES

Citing Literature

References

Information

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Complications of peripherally inserted central catheters in advanced cancer patients undergoing combined radiotherapy and chemotherapy

Abstract

Aims and objectives

Background

Design

Methods

Results

Conclusions

Relevance to clinical practice

REFERENCES

Citing Literature

References

Related

Information