Patients require vascular access for
- Intravenous (IV) administration of medication or fluids (blood or rehydrating fluids) and nutrition if required
- Taking repeated venous blood samples
- To facilitate administration of the following at various stages of an ASCT:
- Conditioning regimen
- Stem cell infusion
- IV drugs such as antibiotics
- Blood products in case of low levels of white blood cells or platelets
- Fluid supplements to address low levels of electrolytes
- As an access point for blood-based treatments such as dialysis or apheresis
- Apheresis involves removing whole blood and separating its individual components to remove one particular component. The remaining blood components are then returned into the patient’s bloodstream.
Most patients with ALL will need the placement of a central venous catheter or a port-a-cath to receive chemotherapy, as well as blood products and antibiotics. Combinations of chemotherapy drugs are generally administered in hospital over about eight weeks which long-term venous access.
Central venous catheters are especially useful for administering irritant drugs such as chemotherapy or multiple drugs needing to be administered at the same time.
Simple IV drug administration can be given as:
- Part of an IV infusion where continuous blood levels are required such as antibiotics, antifungals, and pain-inhibiting drugs such as morphine and other opiates
- A ‘bolus’ of medication over 1–30 mins (Bolger 2018). However, bolus IV administration is infrequently used and often restricted to emergency situations.
