CENTRAL VENOUS CATHETER IN ONCOHEMATOLOGICAL PRACTICE (LECTURE AND OWN DATA)

Abstract

The central vein catheterization provides venous access in oncohematological patients for the administration of large volumes infusions, high-dose chemotherapy, daily administration of drugs, parenteral nutrition, and assessment of central venous pressure. The article provides information on the types of venous catheters, the technique of placing a central venous catheter (CVC) from various vascular accesses. Detailed information is provided on possible complications that arise both during the procedure and when caring for the CVC. The results of own experience of setting up CVC in 2856 patients with diseases of the blood system are also presented. It was shown that among the immediate complications, hematoma (in 4.1 % of cases), puncture of the subclavian artery (2.8 %), immediate (2.7 %) and delayed (2.7 %) bleeding, lymphorrhea (1,4 %), pain and paresthesia (1.6 %), weakness and collapse (1.2 %); less often — an allergic reaction to an anesthetic (0.1 %), pneumothorax (0.2 %), the impossibility of setting up a CVC due to the anatomical features of the patient (0.5 %), bending of the catheter (0.2 %). The delayed complications include catheter integrity failure (0.5 %), CVC extravasation (1.2 %), phlebitis, thrombophlebitis, infiltration (2.6 %), bacteremia and sepsis (2.5 %). The author has shown that the most common bloodstream infection associated with CVC is Gram-positive flora — Staphylococcus epidermidis (50.6 %), Staphylococcus aureus (9 %) and Gram-negative — Esche richia coli (15.7 %), Enterobacter spp. (9 %). Nevertheless, despite the risk of complications during central venous catheterization in patients with oncohematological profile, CVCs remain relevant, but patient preparation and quality care for CVCs are required.