Indications for venous access in oncology – recommendations of national professional societies and current state in the Czech Republic

Česká verze

Authors: Viktor Maňásek ^1-4; Jiří Charvát ^1,3,5; Vendelín Chovanec ^1,6; Lukáš Sirotek ^1,7; Zdeněk Linke ⁸; Štěpán Tuček ^1-3,9,10; Michal Šenkyřík ^1,3,11; Pavel Michálek ^1,12; Martin Polák ^1,3,13; Jitka Fricová ^1,14; Lukáš Daniš ^1,15,16; Lenka Šeflová ^1,15,16; Kateřina Lisová ^1,5; Martina Douglas ^1,16
Authors place of work: Společnost pro porty a permanentní katetry při ČLS JEP ¹; Pracovní skupina nutriční péče v onkologii České onkologické společnosti ²; Společnost klinické výživy a intenzivní metabolické péče ³; Komplexní onkologické centrum, Nemocnice Agel, Nový Jičín ⁴; Interní klinika 2. LF UK a FN Motol, Praha ⁵; Radiologická klinika LF a FN Hradec Králové ⁶; Oddělení chirurgické onkologie, LF MU a MOÚ Brno ⁷; Onkologická klinika 2. LF UK a FN Motol, Praha ⁸; Interní hematologická a onkologická klinika LF MU a FN Brno ⁹; Klinika komplexní onkologické péče MOÚ Brno ¹⁰; Interní gastroenterologická klinika LF MU a FN Brno ¹¹; Klinika anesteziologie, resuscitace a intenzivní medicíny 1. LF UK a VFN v Praze ¹²; Interní oddělení, Klaudiánova nemocnice Mladá Boleslav ¹³; Centrum pro léčbu bolesti, Klinika anesteziologie, resuscitace a intenzivní medicíny 1. LF UK a VFN v Praze ¹⁴; II. interní klinika gastroenterologická a geriatrická, LF UP a FN Olomouc ¹⁵; Úsek nelékařských oborů, FN Olomouc ¹⁶
Published in the journal: Klin Onkol 2021; 34(3): 192-201
Category: Přehled
doi: https://doi.org/10.48095/ccko2021192

Summary

Background: The aim of the paper is to present the current recommendations and indications of venous access in oncology which reflect and recognize the opinions of national and international professional societies. It focuses exclusively on the indications of intravenous catheter placement for anticancer treatment, such as medium-term and long-term venous accesses. Materials and methods: The survey results obtained from a national questionnaire of 24 oncology centers identified the current situation in the Czech Republic. There were evaluated relevant data on the number of and the criteria for the introduction of venous accesses provided by physicians. Comparisons were made between current oncological practice and recommendations provided by evidence-based medicine. Results: At each center surveyed in the Czech Republic, an average of 130 ports and 80 permanent implanted central catheters are introduced annually. The ports are increasingly indicated, with over a half of the centers surveyed introducing ports to more than 100 patients a year, with four centers introducing a total of 1,600 ports annually. In all centers, the decision for venous access is made by an oncologist. However, most procedures are performed by a doctor of another specialization, most often by a surgeon, a radiologist or an anesthesiologist. More than a half of the indications for venous access placement result from poor peripheral venous system or complications of parenteral therapy, not from comprehensive assessment prior to the initiation of the therapy. Conclusion: Based on our findings, we developed general indications and recommendations for venous access to cancer patients which represent the consensus of an interdisciplinary team of specialists, predominantly from the committee of professional societies – the Society for Ports and Permanent Catheters, the Working Group of Nutritional Care in Oncology of the Czech Oncological Society and the Society of Clinical Nutrition and Intensive Metabolic Care. The number of introduced venous access catheters remains insufficient to meet the needs in the Czech Republic, which necessitates increased awareness and possibilities for safe drug administration.

Keywords:

venous access – anticancer treatment – PICC – port – extravasation

Zdroje

Charvát J et al. Žilní vstupy: dlouhodobé a střednědobé. Praha: Grada Publishing, 2016.
Gorski LA, Hadaway L, Hagle ME et al. Infusion therapy standards of practice, 8th ed. J Infus Nurs 2021; 44(1S Suppl 1): S1–S224. doi: 10.1097/ NAN.0000000000000396.
Vokurka S, Maňásek V, Navrátilová Hrabánková D et al. Extravasation (paravasation) of chemotherapy drugs – recommendations for standard care in the Czech republic based on consolations between representatives of the Supportive Care Group of the Czech Society for Oncology, Oncology Section of the Czech Nurses Association, and the Society for Ports and Permanent Catheters. Klin Onkol 2019; 32(6): 463–468. doi: 10.14735/ amko2019463.
Maki DG, Kluger DM, Crnich CJ. The risk of blood- -stream infection in adults with different intravascular device: a systematic review of 200 published prospective studies. Mayo Clin Proc 2006; 81(9): 1159–1171. doi: 10.4065/ 81.9.1159.
Bast RC, Kufe W, Pollock RE et al (eds). Vascular access in cancer patients. Holland-frei cancer medicine. 5th ed. Hamliton (ON): BC Decker 2000.
Gallieni M, Pittiruti M, Biffi R. Vascular access in oncology patiens. CA Cancer J Clin 2008; 58(6): 323–346. doi: 10.3322/ CA.2008.0015.
Dawson, Robert B. PICC Zone Insertion Method™ (ZIM™): a systematic approach to determine the ideal insertion site for PICCs in the upper arm. [online]. Available from: https:/ / meridian.allenpress.com/ java/ article-abstract/ 16/ 3/ 156/ 434169/ PICC-Zone-Insertion-MethodT-ZIMT-A-Systematic?redirectedFrom=fulltext.
Zhang P, Du J, Fan C et al. Utility of totally implantable venous access ports in patients with breast cancer. Breast J 2020; 26(2): 333–334. doi: 10.1111/ tbj.13595.
Qin KR, Pittiruti M, Nataraja RM et al. Long peripheral catheters and midline catheters: insights from a survey of vascular access specialists. J Vasc Access 2020. [in press]. doi: 10.1177/ 1129729820966226.
Qin KR, Nataraja RM, Pacilli M. Long peripheral catheters: Is it time to address the confusion? J Vasc Access 2019; 20(5): 457–460. doi: 10.1177/ 1129729818819730.
Pittiruti M, Hamilton H, Biffi R et al. ESPEN guidelines on parenteral nutrition: central venous catheters (access, care, diagnosis and therapy of complications). Clin Nutr 2009; 28(4): 365–377. doi: 10.1016/ j.clnu.2009.03.015.
Cotogni P, Mussa B, Degiorgis C et al. Comparative complication rates of 854 central venous access devices for home parenteral nutrition in cancer patients: a prospective study of over 169,000 catheter-days. J Parenter Enteral Nutr 2020. [in press]. doi: 10.1002/ jpen.1939.
Bruno J, Todd C, Nicki C et al. Fluids, electrolytes, and acid-based disorders handbook, 2nd ed. American Society for Parenteral and Enteral Nutrition 2020.
van Boxtel T. Vascular acccess – state of art 2019. [online]. Available from: https:/ / www.sppk.eu/ wp-content/ uploads/ 2019/ 12/ State-of-art-2019-WoCoVA-Ton-van-Boxtel.pdf
Vokurka S, Maňásek V, Navrátilová Hrabánková D et al. Extravazace (paravazace) cytostatik – aktualizované doporučení (2020) pro standardní péči v rámci České republiky ze spolupráce Sekce podpůrné léčby České onkologické společnosti ČLS JEP, České hematologické společnosti ČLS JEP, Onkologické sekce České asociace sester a Společnosti pro porty a permanentní katétry. Klin Onkol 2020; 33(5): 390–395. doi: 10.14735/ amko2020390.
Chopra V, Anand S, Hickner A et al. Risk of venous thromboembolism associated with peripherally inserted central catheters: a systematic review and meta-analysis. Lancet 2013; 382(9889): 311–325. doi: 10.1016/ S0140-6736(13)60592-9.
Piredda A, Radice D, Zencovich C et al. Safe use of peripherally inserted central catheters for chemotherapy of solid malignancies in adult patients: a 1-year monocentric, prospectively-assessed, unselected cohort of 482 patients. J Vasc Access 2020. [in press]. doi: 10.1177/ 1129729820962905.
Crocoli A, Cesaro S, Cellini M et al. In defense of the use of peripherally inserted central catheters in pediatric patients. J Vasc Access 2020. [in press]. doi: 10.1177/ 1129729820936411.
Al-Asadi O, Almusarhed M, Eldeeb H. Predictive risk factors of venous thromboembolism (VTE) associated with peripherally inserted central catheters (PICC) in ambulant solid cancer patients: retrospective single centre cohort study. Thromb J 2019; 17: 2. doi: 10.1186/ s12959-019-0191-y.
20.Sillva JT, Lagares-Velasco A, Fernández-Ruiz M et al. Peripherally inserted central venous catheter placed and maintained by a dedicated nursing team for the administration of antimicrobial therapy vs. another type of catheter: a retrospective case-control study. Enferm Infecc Microbiol Clin 2020; 38(9): 425–430. doi: 10.1016/ j.eimc.2020.01.005.
Společnost pro porty a permanentní katétry. Aktuální doporučení pro použití vstupů u pacientů COVIS-19 pozitivních. [online]. Dostupné z: https:/ / www.sppk.eu/ ?p=1495.