PDF(Pubmed)
Abstract：
BACKGROUND: Peripherally inserted central catheters (PICCs) and midline catheters (MCs) may offer convenient intravenous access, but evidence to support their place in palliative care is limited. This review aimed to assess catheter indications, utilization, complications, dwell time, and patient experiences in cancer patients receiving palliative care.
METHODS: A systematic search for studies on catheter utilization for supportive or symptom treatment was conducted in Medline, Embase, CINAHL, Web of Science, Cochrane, and CENTRAL databases. Studies with a study population or a subgroup of palliative care cancer patients were included. Study quality was assessed using the Effective Public Health Practice Quality assessment tool.
RESULTS: Of 7631 unique titles, 17 articles were examined in detail, all published between 2002 and 2022. Median catheter dwell time varied from 15 to 194 days, the longest when utilized for home parenteral nutrition. For pain and symptom management, the typical duration was 2-4 weeks, often until the patient\'s death. Complication rates were minimal, with thrombosis, infections, and occlusion ranging from 0 to 2.46 incidents per 1000 catheter days. In studies from palliative care services, patients reported minimal distress during procedures and high user satisfaction. Quality of life assessments post-procedure improved, possibly influenced by concurrent specialist palliative care provision. All studies were assessed to be of moderate or weak quality.
CONCLUSIONS: PICC and MC are safe and valuable tools in palliative care cancer patients who would benefit from intravenous access for symptom management. Further studies are needed to clarify indications for PICC or MC in palliative care.
METHODS: A systematic search for studies on catheter utilization for supportive or symptom treatment was conducted in Medline, Embase, CINAHL, Web of Science, Cochrane, and CENTRAL databases. Studies with a study population or a subgroup of palliative care cancer patients were included. Study quality was assessed using the Effective Public Health Practice Quality assessment tool.
RESULTS: Of 7631 unique titles, 17 articles were examined in detail, all published between 2002 and 2022. Median catheter dwell time varied from 15 to 194 days, the longest when utilized for home parenteral nutrition. For pain and symptom management, the typical duration was 2-4 weeks, often until the patient\'s death. Complication rates were minimal, with thrombosis, infections, and occlusion ranging from 0 to 2.46 incidents per 1000 catheter days. In studies from palliative care services, patients reported minimal distress during procedures and high user satisfaction. Quality of life assessments post-procedure improved, possibly influenced by concurrent specialist palliative care provision. All studies were assessed to be of moderate or weak quality.
CONCLUSIONS: PICC and MC are safe and valuable tools in palliative care cancer patients who would benefit from intravenous access for symptom management. Further studies are needed to clarify indications for PICC or MC in palliative care.
摘要：
背景：经外周插入的中央导管（PICC）和中线导管（MC）可以提供方便的静脉通路，但是支持他们在姑息治疗中地位的证据是有限的。本综述旨在评估导管适应症，利用率，并发症,停留时间,以及接受姑息治疗的癌症患者的患者体验。
方法：在Medline进行了关于导管使用支持或症状治疗的系统研究，Embase,CINAHL,WebofScience,科克伦,和中央数据库。包括研究人群或姑息治疗癌症患者亚组的研究。使用有效公共卫生实践质量评估工具评估研究质量。
结果：在7631个独特的标题中，详细研究了17篇文章，均在2002年至2022年之间发布。导管中值停留时间从15天到194天不等。用于家庭肠外营养的时间最长。对于疼痛和症状管理，典型的持续时间是2-4周，通常直到病人死亡。并发症发生率很低，血栓形成，感染,和闭塞范围从0到2.46事件/1000导管天。在姑息治疗服务的研究中，患者在手术过程中报告的痛苦最小，用户满意度高。术后生活质量评估有所改善，可能受同时提供专科姑息治疗的影响。所有研究均被评估为中等或较弱的质量。
结论：PICC和MC是姑息治疗癌症患者的安全和有价值的工具，他们将受益于静脉介入治疗的症状管理。需要进一步的研究来阐明PICC或MC在姑息治疗中的适应症。
方法：在Medline进行了关于导管使用支持或症状治疗的系统研究，Embase,CINAHL,WebofScience,科克伦,和中央数据库。包括研究人群或姑息治疗癌症患者亚组的研究。使用有效公共卫生实践质量评估工具评估研究质量。
结果：在7631个独特的标题中，详细研究了17篇文章，均在2002年至2022年之间发布。导管中值停留时间从15天到194天不等。用于家庭肠外营养的时间最长。对于疼痛和症状管理，典型的持续时间是2-4周，通常直到病人死亡。并发症发生率很低，血栓形成，感染,和闭塞范围从0到2.46事件/1000导管天。在姑息治疗服务的研究中，患者在手术过程中报告的痛苦最小，用户满意度高。术后生活质量评估有所改善，可能受同时提供专科姑息治疗的影响。所有研究均被评估为中等或较弱的质量。
结论：PICC和MC是姑息治疗癌症患者的安全和有价值的工具，他们将受益于静脉介入治疗的症状管理。需要进一步的研究来阐明PICC或MC在姑息治疗中的适应症。
