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

Czech version

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‘ workplace: 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: Klin Onkol 2021; 34(3): 192-201
Category: Review
doi: https://doi.org/10.48095/ccko2021192

Overview

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

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