Introduction: Placement of central venous catheters (CVCs) is a common clinical practice, but associated with significant risks, including mechanical complications and infections. In response to these challenges, peripheral venous catheters (PICCs) have emerged as a safer and more convenient alternative. However, both options have risks and complications, including Medical Adhesive Related Skin Injury (MARSI), Catheter-Related Bloodstream Infections (CRBSI), and catheter occlusion. Materials and methods: to prepare this literature review, scientific articles in English were searched using the PubMed biomedical database. The review question formulated is the following: "In adult patients with PICCs and central venous catheters, what are the management techniques and medications that, according to the evidence in the literature, prevent and/or reduce the incidence of MARSI, CRBSI and occlusion of the lumen?”. The search for articles was filtered to select "free full text" articles in the period from 2013 to 2023. Finally, titles and abstracts were read to exclude the less interesting articles with a total of 10 articles selected for the thesis. Objective: The objective of this literature review is to contribute to the prevention and/or reduction of complications, specifically focusing on phenomena such as Medical Adhesive-Related Skin Injury (MARSI), Catheter-Related Bloodstream Infection (CRBSI) and the occlusion of the lumen. Results: the studies analyzed confirm the effectiveness of specific recommendations to manage skin lesions caused by medical adhesives and the use of skin barriers. Other findings confirmed the effectiveness of antibiotic coatings and chlorhexidine gel dressings in preventing infections. Needle-free decontamination of connectors and flushing with saline were essential to maintain patency of venous catheters. Finally, the use of normal saline solution was advantageous over heparinized solution to maintain the patency of the venous access. Conclusions: The analyzed literature offers important contributions to the understanding, prevention and management of complications related to central venous catheters and peripherally inserted central catheters, but further studies are needed to address gaps in the literature and develop more effective and safe approaches for prevention and the management of these complications.
Introduzione: Il posizionamento dei cateteri venosi centrali (CVC) è una pratica clinica comune, ma associata a rischi significativi, tra cui complicanze meccaniche e infezioni. In risposta a queste sfide, i cateteri venosi periferici (PICC) sono emersi come un'alternativa più sicura e conveniente. Tuttavia, entrambe le opzioni presentano rischi e complicanze, tra cui la Medical Adhesive Related Skin Injury (MARSI), le infezioni del flusso sanguigno correlate al catetere (CRBSI) e l'occlusione del catetere. Materiali e metodi: per la stesura di questa revisione della letteratura sono stati ricercati articoli scientifici in lingua inglese utilizzando la banca dati biomedica PubMed. Il quesito di revisione formulato è il seguente: “Nei pazienti adulti con PICC e cateteri venosi centrali, quali sono le tecniche di gestione e le medicazioni che secondo le evidenze presenti in letteratura, prevengono e/o riducono l’incidenza di MARSI, CRBSI e occlusione del lume?”. La ricerca degli articoli è stata filtrata per selezionare articoli “free full text” nell’arco temporale dal 2013 al 2023. Sono stati infine letti titoli ed abstract per escludere gli articoli meno interessanti con un totale di 10 articoli selezionati per la tesi. Obiettivo: l’obiettivo di questa revisione della letteratura è contribuire alla prevenzione e/o riduzione delle complicanze, focalizzandosi specificamente su fenomeni come la lesione cutanea correlata agli adesivi medicali (MARSI), l'Infezione del Flusso Ematico Correlata al Catetere (CRBSI) e l'occlusione del lume. Risultati: dagli studi analizzati si conferma l'efficacia di raccomandazioni specifiche per gestire le lesioni cutanee da adesivo medico e l'uso di barriere cutanee. Altri risultati hanno confermato l'efficacia di rivestimenti antibiotici e medicazioni con gel in clorexidina nel prevenire le infezioni. È risultata essenziale la decontaminazione dei connettori senza ago e il lavaggio con soluzione fisiologica per mantenere la pervietà dei cateteri venosi. Infine, è risultato vantaggioso l'uso di soluzione fisiologica normale rispetto a soluzione eparinata per mantenere la pervietà dell'accesso venoso. Conclusioni: la letteratura analizzata offre importanti contributi alla comprensione, prevenzione e gestione delle complicanze correlate ai cateteri venosi centrali e i cateteri centrali ad inserzione periferica, ma sono necessari ulteriori studi per affrontare le lacune nella letteratura e sviluppare approcci più efficaci e sicuri per la prevenzione e la gestione di tali complicanze.
Gestione e prevenzione delle complicanze correlate ai PICC e cateteri venosi centrali: revisione narrativa della letteratura
CORRADINI, MATTEO
2022/2023
Abstract
Introduction: Placement of central venous catheters (CVCs) is a common clinical practice, but associated with significant risks, including mechanical complications and infections. In response to these challenges, peripheral venous catheters (PICCs) have emerged as a safer and more convenient alternative. However, both options have risks and complications, including Medical Adhesive Related Skin Injury (MARSI), Catheter-Related Bloodstream Infections (CRBSI), and catheter occlusion. Materials and methods: to prepare this literature review, scientific articles in English were searched using the PubMed biomedical database. The review question formulated is the following: "In adult patients with PICCs and central venous catheters, what are the management techniques and medications that, according to the evidence in the literature, prevent and/or reduce the incidence of MARSI, CRBSI and occlusion of the lumen?”. The search for articles was filtered to select "free full text" articles in the period from 2013 to 2023. Finally, titles and abstracts were read to exclude the less interesting articles with a total of 10 articles selected for the thesis. Objective: The objective of this literature review is to contribute to the prevention and/or reduction of complications, specifically focusing on phenomena such as Medical Adhesive-Related Skin Injury (MARSI), Catheter-Related Bloodstream Infection (CRBSI) and the occlusion of the lumen. Results: the studies analyzed confirm the effectiveness of specific recommendations to manage skin lesions caused by medical adhesives and the use of skin barriers. Other findings confirmed the effectiveness of antibiotic coatings and chlorhexidine gel dressings in preventing infections. Needle-free decontamination of connectors and flushing with saline were essential to maintain patency of venous catheters. Finally, the use of normal saline solution was advantageous over heparinized solution to maintain the patency of the venous access. Conclusions: The analyzed literature offers important contributions to the understanding, prevention and management of complications related to central venous catheters and peripherally inserted central catheters, but further studies are needed to address gaps in the literature and develop more effective and safe approaches for prevention and the management of these complications.| File | Dimensione | Formato | |
|---|---|---|---|
|
tesi completa senza frontespizio.pdf
accesso aperto
Dimensione
463.65 kB
Formato
Adobe PDF
|
463.65 kB | Adobe PDF | Visualizza/Apri |
I documenti in UNITESI sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
https://hdl.handle.net/20.500.12075/17415