Prospective evaluation of systematic use of peripherally inserted central catheters (PICC lines) for the home care after allogeneic hematopoietic stem cells transplantation.

PURPOSE: Long-term catheters are often necessary for outpatient care after an allogeneic hematopoietic stem cell transplantation (HSCT), However, there is paucity of data on the use of peripherally inserted central catheter (PICC) in post-HSCT setting. METHODS: We prospectively evaluated the systematic use of PICC in 37 consecutive patients returning home after HSCT. RESULTS: In 6 out of 37 patients, the PICC was exclusively used for weekly blood controls. In 31 patients, the PICC line was used at home for hydration (18), antibiotics (3), intravenous human Ig (7), transfusions (10), extracorporeal photopheresis (3), chemotherapy (2), artificial nutrition (1), and/or palliative care (1). PICC complications were reported in ten patients (27%), causing eight PICC removals. At the end of the study, 35 patients had their PICC removed. PICCs were used with a median duration of 67 days. Reasons for removal were that PICC was not considered to be useful any longer (16), suspicion of infection (inflammation without documentation) (5) or infection (2), patient's wish (4), death (4), accidental withdrawal (2), puncture site bleeding (1), and catheter change due to extracorporeal photopheresis (1). Three venous thromboses were reported (8%), requesting one PICC removal because of associated infection. In other cases, an antithrombotic treatment was initiated. CONCLUSIONS: Although the number of patients included in the study was small, our results suggest that PICC is a safe long-term venous access for home care after HSCT.

[Toxicity of lead nitrate to the carp (Cyprinus carpio L.). Effect on respiratory metabolism and histological structure of gill lamellae (author's transl)]. / Intoxication par le nitrate de plomb chex la carpe (Cyprinus carpio L.). Influence sur le métabolisme respiratoire et la structure des filaments branchiaux.

Oxygen uptake of gills was estimated after lead poisoning of the Carp. Histological structure of gill lamellae was also examined. Oxygen uptake quickly decreased after two weeks then increased again in long term poisoning without total recovery. On the other hand, desquamation of the gill epithelium was observed as well as proliferation of mast cells probably loaded with lead. The return to clean water for eleven weeks, allowed the lamellar epithelium recovery but not the mast cells elimination.