2.50
Hdl Handle:
http://hdl.handle.net/10755/164885
Category:
Abstract
Type:
Presentation
Title:
PREVENTION OF HEMORRHAGIC CYSTITIS: THE EVIDENCE SAYS WHAT?!
Author(s):
Sylvanus, Terry
Author Details:
Terry Sylvanus, MSN APRN BC AOCN, RN V, H Lee Moffitt Cancer Center, Tampa, Florida, USA, email: sylvantl@moffitt.org
Abstract:
Hemorrhagic cystitis is a recognized toxicity of high-dose cyclophosphamide administration, which historically occurred in 40-70% of patients who received it without prophylaxis during conditioning for hematopoietic stem cell transplant (HSCT). Three disparate therapies are currently used to protect against this significant complication: hyperhydration with forced diuresis, continuous bladder irrigation, and administration of mesna, depending on transplant center and physician preferences. This review was designed to determine what evidence exists to support the use of each of three therapeutic interventions designed to prevent hemorrhagic cystitis in HCST patients receiving high-dose Cyclophosphamide. An algorithm will be designed to guide the practitioner in the selection of an appropriate preventive strategy, based on patient variables, as well as therapeutic benefits and risks. An expert oncology nurse reviewed published guidelines, reviews and studies from 1986-2006 located through Pubmed using evidence based practice filters, and through CINAHL using relevant search terms. Selection criteria for inclusion in the review was limited to randomized, prospective, controlled trials of the efficacy of hyperhydration, CBI or mesna in the prevention of hemorrhagic cystitis in HSCT patients. Available national nursing and medical guidelines, pertinent studies and reviews were summarized into an evidence table format, and a clinical algorithm was developed. The importance of evaluation and consideration of patient variables and preferences in the development of evidence-based practice guidelines was highlighted. No studies reviewed provided sufficient evidence as to the clear superiority of any one of the three therapeutic strategies in prevention of hemorrhagic cystitis; rather, each intervention is appropriate in defined clinical circumstances. Use of the developed clinical algorithm would encourage standardization of transplant protocols regardless of institutional and practitioner preferences. There is also a very real need for well-designed, randomized, controlled, interdisciplinary research to address this issue in this population.
Repository Posting Date:
27-Oct-2011
Date of Publication:
27-Oct-2011
Conference Date:
2007
Conference Name:
32nd Annual Oncology Nursing Society Congress
Conference Host:
Oncology Nursing Society
Conference Location:
Las Vegas, Nevada, USA
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.type.categoryAbstracten_US
dc.typePresentationen_GB
dc.titlePREVENTION OF HEMORRHAGIC CYSTITIS: THE EVIDENCE SAYS WHAT?!en_GB
dc.contributor.authorSylvanus, Terryen_US
dc.author.detailsTerry Sylvanus, MSN APRN BC AOCN, RN V, H Lee Moffitt Cancer Center, Tampa, Florida, USA, email: sylvantl@moffitt.orgen_US
dc.identifier.urihttp://hdl.handle.net/10755/164885-
dc.description.abstractHemorrhagic cystitis is a recognized toxicity of high-dose cyclophosphamide administration, which historically occurred in 40-70% of patients who received it without prophylaxis during conditioning for hematopoietic stem cell transplant (HSCT). Three disparate therapies are currently used to protect against this significant complication: hyperhydration with forced diuresis, continuous bladder irrigation, and administration of mesna, depending on transplant center and physician preferences. This review was designed to determine what evidence exists to support the use of each of three therapeutic interventions designed to prevent hemorrhagic cystitis in HCST patients receiving high-dose Cyclophosphamide. An algorithm will be designed to guide the practitioner in the selection of an appropriate preventive strategy, based on patient variables, as well as therapeutic benefits and risks. An expert oncology nurse reviewed published guidelines, reviews and studies from 1986-2006 located through Pubmed using evidence based practice filters, and through CINAHL using relevant search terms. Selection criteria for inclusion in the review was limited to randomized, prospective, controlled trials of the efficacy of hyperhydration, CBI or mesna in the prevention of hemorrhagic cystitis in HSCT patients. Available national nursing and medical guidelines, pertinent studies and reviews were summarized into an evidence table format, and a clinical algorithm was developed. The importance of evaluation and consideration of patient variables and preferences in the development of evidence-based practice guidelines was highlighted. No studies reviewed provided sufficient evidence as to the clear superiority of any one of the three therapeutic strategies in prevention of hemorrhagic cystitis; rather, each intervention is appropriate in defined clinical circumstances. Use of the developed clinical algorithm would encourage standardization of transplant protocols regardless of institutional and practitioner preferences. There is also a very real need for well-designed, randomized, controlled, interdisciplinary research to address this issue in this population.en_GB
dc.date.available2011-10-27T12:08:43Z-
dc.date.issued2011-10-27en_GB
dc.date.accessioned2011-10-27T12:08:43Z-
dc.conference.date2007en_US
dc.conference.name32nd Annual Oncology Nursing Society Congressen_US
dc.conference.hostOncology Nursing Societyen_US
dc.conference.locationLas Vegas, Nevada, USAen_US
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.-
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