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血液学和肿瘤学相关的中心静脉导管感染:感染性疾病工作组(AGIHO)更新的诊断、管理和预防指南,由德国血液学和肿瘤学学会(DGHO)制定。

Central venous catheter-related infections in hematology and oncology: 2020 updated guidelines on diagnosis, management, and prevention by the Infectious Diseases Working Party (AGIHO) of the German Society of Hematology and Medical Oncology (DGHO).

机构信息

Department I of Internal Medicine, Hematology and Oncology, Intensive Care Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, University of Cologne, Kerpener Strasse 62, 50937, Cologne, Germany.

Department of Hematology and Oncology, Otto-von-Guericke University Magdeburg, Medical Center, Magdeburg, Germany.

出版信息

Ann Hematol. 2021 Jan;100(1):239-259. doi: 10.1007/s00277-020-04286-x. Epub 2020 Sep 30.

Abstract

Cancer patients frequently require central venous catheters for therapy and parenteral nutrition and are at high risk of central venous catheter-related infections (CRIs). Moreover, CRIs prolong hospitalization, cause an excess in resource utilization and treatment cost, often delay anti-cancer treatment, and are associated with a significant increase in mortality in cancer patients. We therefore summoned a panel of experts by the Infectious Diseases Working Party (AGIHO) of the German Society of Hematology and Medical Oncology (DGHO) and updated our previous guideline on CRIs in cancer patients. After conducting systematic literature searches on PubMed, Medline, and Cochrane databases, video- and meeting-based consensus discussions were held. In the presented guideline, we summarize recommendations on definition, diagnosis, management, and prevention of CRIs in cancer patients including the grading of strength of recommendations and the respective levels of evidence. This guideline supports clinicians and researchers alike in the evidence-based decision-making in the management of CRIs in cancer patients.

摘要

癌症患者经常需要接受中心静脉导管治疗和肠外营养,因此存在发生中心静脉导管相关性感染(CRI)的高风险。此外,CRI 会延长住院时间,导致资源利用和治疗费用增加,常常会延误癌症治疗,并且与癌症患者的死亡率显著增加相关。因此,我们召集了感染病工作组(AGIHO)的专家以及德国血液学和肿瘤医学学会(DGHO),对之前关于癌症患者 CRI 的指南进行了更新。在对 PubMed、Medline 和 Cochrane 数据库进行系统文献检索后,我们通过视频会议和现场会议进行了共识讨论。在本指南中,我们总结了癌症患者 CRI 的定义、诊断、管理和预防建议,包括推荐强度分级和相应的证据水平。本指南为临床医生和研究人员在癌症患者 CRI 管理的循证决策中提供支持。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9cd5/7782365/cd3593cd09f2/277_2020_4286_Fig1_HTML.jpg

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