DELAYED COMPLICATIONS OF CENTRAL VENOUS CATHETER IN PATIENTS UNDERWENT BONE MARROW TRANSPLANTATION IN SULAIMANI CITY/IRAQ

Abstract

Background: Central venous catheter is essential in the management of patients undergoing bone marrow transplants, however, insertion of it has often the potential of inducing major complications. Aim: The aim of the study was to assess central venous catheter-related complications in patients underwent bone marrow transplants. Methodology: A retrospective study was carried out at Shahid Shaswary Garmian for bone marrow transplantation in Sulaimani City on 112 adult patients who underwent bone marrow transplants from June 2016 to May 2021. The patient's medical records were used to collect data regarding; patients' and CVCs characteristics, intravenous infusions, CVC-related complications; the number and type of complication. Results: The age of 52.7% was between 40-60 years, most of them were male, primary school, and from urban. The medical diagnosis for (43.8%) was multiple myeloma, majority underwent autologous transplant, Hickman line was used for 48.2%, internal jugular vein was a most used vein, the length of stay with a catheter for almost 70% was between 2 to 3 weeks, and the majority had 2 dressing per week, most of the participants received 2 bags of Fresenius, 51.8% received blood, and 92% received platelet. The catheter-related complications occurred in 65.2% of participants, the number and type of complications were varied; 42% had one, 19.6% two, and 3.6% three complications, the proportion of fibrin was 42.9% followed by infection 32.1, occlusion 10.7%, and hematoma 7.1%. The incidence of complications was higher in leukemic patients, who had allogeneic transplants and used Hickman line 88.9%. In addition, using internal jugular vein for insertion 90%, long stay with the catheter (≥ 4 weeks) 89.3% and fewer number of dressing (1 dressing/week) 100% were more problematic. Conclusions: The incidence of central venous catheter-related complications was high, almost two-thirds had at least one complication. The most common complications were fibrin and infection. The incidence of complications affects by patients' medical diagnosis, type of transplant and catheter, vein used for insertion of the catheter, the duration of stay with a catheter, and the number of dressings for catheters sit.