BACKGROUND: Central venous catheter (CVC) is the mandatory device for the administration of chemotherapy and support therapy to patients, particularly to children affected by malignancies. One of the major draw-backs of the extended use of CVC is the occurrence of CVC-related infections (CVC-RI) which represent an important cause of morbidity and mortality. In order to reduce the incidenceof the removal of CVCs due to the persistent CVC -related infection, a new treatment based on a highly concentrated antibiotic lock solution instilled into the catheter lumen was proposed. AIMS: To describe the experience and results of the implementation of the lock therapy (associated to the use of connector CLC 2000) in a sample of patients of the oncoematology paediatric ward of Padova Hospital. MATERIAL AND METHODS: Sample. 11 patients (4-21 years of age), affected by CVCRI. 10 patients had a 2 way tunneled catheter and one an implanted Port. A connector CLC 2000 was inserted to 9 patients with CVC. TREATMENT: An antibiotic lock therapy was administered for an average duration of 6.3 days: to the 9 patients with CLC 2000 no heparin was added. Success wasdefined in terms of absence of feverfor at least 7 days in patients febrile atbaseline; negativization of previously positive CVC blood culture without removal of CVC within 30 days starting from lock therapy.RESULTS: Only in one out of 11 patients a negative outcome led to CVC removal. Problems with a malfunctioning device had to be solved also in one patient. CONCLUSION: The antibiotic lock therapy is a promising method to treat the CVCRI although the experience on oncohematological patients is limited. The use of connector CLC 2000 may improve the technique and reduce the problems.

The antibiotic-lock therapy in oncoematology pediatric unit

CESARO, SIMONE
2005

Abstract

BACKGROUND: Central venous catheter (CVC) is the mandatory device for the administration of chemotherapy and support therapy to patients, particularly to children affected by malignancies. One of the major draw-backs of the extended use of CVC is the occurrence of CVC-related infections (CVC-RI) which represent an important cause of morbidity and mortality. In order to reduce the incidenceof the removal of CVCs due to the persistent CVC -related infection, a new treatment based on a highly concentrated antibiotic lock solution instilled into the catheter lumen was proposed. AIMS: To describe the experience and results of the implementation of the lock therapy (associated to the use of connector CLC 2000) in a sample of patients of the oncoematology paediatric ward of Padova Hospital. MATERIAL AND METHODS: Sample. 11 patients (4-21 years of age), affected by CVCRI. 10 patients had a 2 way tunneled catheter and one an implanted Port. A connector CLC 2000 was inserted to 9 patients with CVC. TREATMENT: An antibiotic lock therapy was administered for an average duration of 6.3 days: to the 9 patients with CLC 2000 no heparin was added. Success wasdefined in terms of absence of feverfor at least 7 days in patients febrile atbaseline; negativization of previously positive CVC blood culture without removal of CVC within 30 days starting from lock therapy.RESULTS: Only in one out of 11 patients a negative outcome led to CVC removal. Problems with a malfunctioning device had to be solved also in one patient. CONCLUSION: The antibiotic lock therapy is a promising method to treat the CVCRI although the experience on oncohematological patients is limited. The use of connector CLC 2000 may improve the technique and reduce the problems.
CVC, antibiotic lock, complication
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/11562/779405
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