A GAVeCeLT consensus on the indication, insertion, and management of central venous access devices in the critically ill

作者：F. Pinelli, Mauro Pittiruti, M. Annetta, F. Barbani, S. Bertoglio, D. Biasucci, Denise Bolis, F. Brescia, Giuseppe Capozzoli, Sonia D’Arrigo, Elisa Deganello, Stefano Elli, Adam Fabiani, F. Fabiani, A. Gidaro, Davide Giustivi, E. Iacobone, A. La Greca, F. Longo, A. Lucchini, Bruno Marche, Stefano Romagnoli, G. Scoppettuolo, Valentina Selmi, Davide Vailati, Gianluca Villa, Gilda Pepe · 发表于：Journal of Vascular Access · 年份：2024 · DOI：10.1177/11297298241262932 · 被引用次数：43 · 研究领域：Medicine

Central venous access devices are essential for the management of critically ill patients, but they are potentially associated with many complications, which may occur during or after insertion. Many evidence-based documents—consensus and guidelines—suggest practical recommendations for reducing catheter-related complications, but they have some limitations. Some documents are not focused on critically ill patients; other documents address only some special strategies, such as the use of ultrasound; other documents are biased by obsolete concepts, inappropriate terminology, and lack of considerations for new technologies and new methods. Thus, the Italian Group of Venous Access Devices (GAVeCeLT) has decided to offer an updated compendium of the main strategies—old and new—that should be adopted for minimizing catheter-related complications in the adult critically ill patient. The project has been planned as a consensus, rather than a guideline, since many issues in this field are relatively recent, and few high-quality randomized clinical studies are currently available, particularly in the area of indications and choice of the device. Panelists were chosen between the Italian vascular access experts who had published papers on peer-reviewed journals about this topic in the last few years. The consensus process was carried out according to the RAND/University of California at Los Angeles (UCLA) Appropriateness Methodology, a modification of the Delphi method, that is, a stru...