Insertion site of central venous catheter correlates with catheter-related infectious events in patients undergoing intensive chemotherapy

• Published in: Bone marrow transplantation (Basingstoke) Vol. 56; no. 1; pp. 195 - 201
• Main Authors: Rixecker, Torben, Lesan, Vadim, Ahlgrimm, Manfred, Thurner, Lorenz, Bewarder, Moritz, Murawski, Niels, Christofyllakis, Konstantinos, Altmeyer, Sarah, Bick, Angelika, Stilgenbauer, Stephan, Bittenbring, Joerg Thomas, Kaddu-Mulindwa, Dominic
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 01.01.2021; Nature Publishing Group
• Subjects: 692/699/1541; 692/699/1541/1990/283; Bone marrow; Bone marrow transplantation; Cancer; Catheters; Cell Biology; Central venous catheters; Chemotherapy; Complications and side effects; Dosage and administration; Hematology; Hematopoietic stem cells; Inflammation; Insertion; Internal Medicine; Medical instruments; Medicine; Medicine & Public Health; Neutropenia; Patient outcomes; Public Health; Risk factors; Stem cell transplantation; Stem Cells; Subgroups; Transplantation; Germany
• ISSN: 0268-3369; 1476-5365; 1476-5365
• DOI: 10.1038/s41409-020-01003-0

Patients undergoing intensive chemotherapy are usually in need for central venous catheters (CVC). Due to contradictory study results, relation of insertion site and CVC-associated complication rate in these patients is not clear. We therefore retrospectively analyzed CVC-related data of all patients undergoing intensive chemotherapy with high risk of febrile neutropenia according to NCCN criteria, who received a CVC at our bone marrow transplantation unit between May 2016 and December 2019. In total, 210 patients received 281 CVC. CVC were placed via either the subclavian-vein (SCV, n  = 58; 20%) or the internal-jugular-vein (IJV, n  = 223; 80%). Median duration of CVC-lifetime and neutropenic days per CVC were comparable between the two groups (IJV vs SCV: 23 days vs 21 days ( p  = 0.16) and 12 days vs 11 days ( p  = 0.65)). Both, time to CVC removal due to local inflammation and time to central line-associated bloodstream infection was significantly shorter in patients with SCV catheters ( p  = 0.013 and p  = 0.045). CVC placed in the IJV were associated with significantly less catheter-related infectious events compared with CVC placed in the SCV. This difference was consistent across different subgroups including 88 patients undergoing allogeneic stem cell transplantation.