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“Central venous (CV) ports are being used increasingly in both hospital and home care settings. Here, we investigated the rates and causes of CV port complications” Okada et al (2014).

Abstract:

PURPOSE: Central venous (CV) ports are being used increasingly in both hospital and home care settings. Here, we investigated the rates and causes of CV port complications.

MATERIALS AND METHODS: We retrospectively analyzed the placement of 264 consecutive CV ports in 239 consecutive patients admitted to our hospital between September 2009 and February 2012. All CV ports were inserted under fluoroscopy and ultrasound visualization by interventional radiologists using maximum barrier precautions. CV port complications were checked in detail and analyzed statistically.

RESULTS: Total indwelling time for all CV ports was 51,033 catheter days. Of the 264 CV ports assessed, 50 were removed during the study period because of any complication and 147 remained at the end of the study period. In 33 cases, the patient died before the end of the study. Of the 50 patients who underwent CV port removal, 13 were diagnosed as having catheter-related bloodstream infection (CRBSI). The total rate of CV port removal because of any complication was 0.98 cases per 1,000 catheter days, that of catheter troubles was 0.22 cases per 1,000 catheter days and that of CRBSI was 0.25 cases per 1,000 catheter days. Steroid administration and total parenteral nutrition (TPN) were associated with increased rates of infection. It seems that chemotherapy and indwelling time were also considered important factors.

CONCLUSION: Steroid administration and TPN were associated with increased rates of infection. In addition, patients receiving chemotherapy or whose CV ports are left in place for a long time should be carefully observed to decrease these complications.

Reference:

Okada, S., Shiraishi, A., Yamashiro, Y., Inoue, T., Tsuge, D., Aida, M. and Kuwatsuru, R. (2014) A retrospective statistical analysis of the late complications associated with central venous port placements. Japanese Journal of Radiology. November 30th. (epub ahead of print).