Central venous catheter care for the patient with cancer: American Society of Clinical Oncology clinical practice guideline.
Research article published in Journal of clinical oncology : official journal of the American Society of Clinical Oncology (2013)
Abstract
PURPOSE: To develop an evidence-based guideline on central venous catheter (CVC) care for patients with cancer that addresses catheter type, insertion site, and placement as well as prophylaxis and management of both catheter-related infection and thrombosis. METHODS: A systematic search of MEDLINE and the Cochrane Library (1980 to July 2012) identified relevant articles published in English. RESULTS: The overall quality of the randomized controlled trial evidence was rated as good. There is consistency among meta-analyses and guidelines compiled by other groups as well. RECOMMENDATIONS: There is insufficient evidence to recommend one CVC type or insertion site; femoral catheterization should be avoided. CVC should be placed by well-trained providers, and the use of a CVC clinical care bundle is recommended. The use of antimicrobial/antiseptic-impregnated and/or heparin-impregnated CVCs is recommended to decrease the risk of catheter-related infections for short-term CVCs, particularly in high-risk groups; more research is needed. The prophylactic use of systemic antibiotics is not recommended before insertion. Data are not sufficient to recommend for or against routine use of antibiotic flush/lock therapy; more research is needed. Before starting antibiotic therapy, cultures should be obtained. Some life-threatening infections require immediate catheter removal, but most can be treated with antimicrobial therapy while the CVC remains in place. Routine flushing with saline is recommended. Prophylactic use of warfarin or low-molecular weight heparin is not recommended, although a tissue plasminogen activator (t-PA) is recommended to restore patency to occluded catheters. CVC removal is recommended when the catheter is no longer needed or if there is a radiologically confirmed thrombosis that worsens despite anticoagulation therapy.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Resumen
To develop an evidence-based guideline on central venous catheter (CVC) care for patients with cancer that addresses catheter type, insertion site, and placement as well as prophylaxis and management of both catheter-related infection and thrombosis. A systematic search of MEDLINE and the Cochrane...
Por qué esto importa para la hirudoterapia
This article presents an evidence-based guideline on central venous catheter care for patients with cancer, addressing catheter type, insertion site, placement, and prophylaxis and management of catheter-related infection and thrombosis. Recommendations include using care bundles, antimicrobial or heparin-impregnated catheters for short-term use in high-risk groups, routine saline flushing, and t-PA for restoring patency to occluded catheters; prophylactic warfarin or low-molecular weight heparin is not recommended. For ASH's domain, any relevance is limited to the general clinical context of anticoagulant use in vascular access devices. The abstract does not mention leeches, hirudotherapy, or the leech secretome, so there is no defensible leech-specific link to ASH's domain.
Citación
Central venous catheter care for the patient with cancer: American Society of Clinical Oncology clinical practice guideline.
Schiffer et al. · Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2013
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Añadido a la biblioteca ASH: May 28, 2026 · Última actualización del sitio: June 18, 2026