Study of complications associated with central vein catheterization in patients with blood disorder

Introduction. Central venous catheter (CVC) provides intensive infusion and transfusion therapy in cancer patients, but catheter placement and operation are often associated with complications. Objective. To determine the incidence of complications associated with CVC in patients with blood disorders. Materials and methods. The study involved 3115 patients and 46 bone marrow donors. The right subclavian vein was catheterized in 2600 (82.2%) patients, the left subclavian vein in 552 patients (17.5%), and the internal jugular vein in 9 patients (0.3%). All persons underwent radiologic control; bacteriological blood examination was performed in case of suspected infection. Results. Early revealed complications were: hematoma in 4.0% of patients; bleeding — in 2.3%; subclavian artery puncture — in 2.7%; pain and paresthesia of the upper limb — in 1.7%; lymphorrhea — in 1.4%; weakness / collapse — in 1.2%; extravasation — in 1.1%; catheter thrombosis — in 1.1%; less frequently, pneumothorax was detected in 0.2% of patients; allergic reaction to anesthetic — in 0.1%. Delayed complications (infiltrate, phlebitis, thrombophlebitis) were diagnosed in 2.7% of patients, bacteremia — in 2.4%, delayed bleeding — 0.4%. Among infections, Gram positive microorganisms were more frequently detected in 61.8% of cases, Gram negative in 29.7% ( p < 0.01), and rarely fungal pathogens in 8.5% ( p < 0.001). It was not possible to catheterize the central vein due to anatomical features of the patient in 0.5% of cases. Conclusions. The analysis of trunk vein catheterization in patients with blood disorders established a high rate of hematomas, bleeding, subclavian artery punctures; among delayed complications, infiltrate, phlebitis, and bacteremia. Infectious complications demonstrated a prevalence of Gram-positive infectious agents.