Clinical analysis of central venous catheter in 3 930 patients with tumors

Abstract

Objective: To explore the value of central venous catheter (CVC) in clinical management of patients with various tumors, and to compare the advantages and disadvantages of various CVCs. Methods: Three thousand nine hundred and thirty patients admitted into the department of oncology at our hospital during July 31, 2000 and July 31, 2013 received four kinds of CVC, including subclavian central venous catheter, peripherally inserted central catheter CVC (PICC), transjugular CVC, and femoral vein catheterization. We compared the success rate, complications, comfort, costs, and some other aspects to evaluate the advantages and setbacks of each CVC, respectively. Results: (1) All kinds of CVC had a high success rate, while subclavian CVC demonstrated a slightly superior result. (2) The infectious complications were 0% for transjugular CVC, 21.31% for subclavian CVC, 17.02% for PICC, and 22.22% for femoral vein catheterization, respectively. (3) For mechanical complications, subclavian CVC had the lowest incidence, while PICC had the highest incidence. Transjugular CVC had few problems than the other three kinds, while subclavian CVC had more problems. (4) Infectious and severe mechanical complications (such as venous thrombosis, phlebitis): subclavian CVC had the lowest incidence, transjugular CVC followed, then PICC, and femoral vein catheterization had the highest incidence. (5) Comfort and acceptance by patients: Subcordic CVC had the most comfort and well accepted by patients, PICC comes in second. (6) No death associated with complications. Conclusions: Every kind of CVC had its advantages and disadvantages, and can be applied according to patient’s situation and actual needs. Generally speaking, we suggest apply CVC as the following order: subclavian CVC, PICC, transjugular CVC, and femoral vein catheterization. Key words: Department of oncology; Central venous catheter; Complication; Advantages and disadvantages; Order of selection