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Complications associated with implantable port use in infants

To evaluate technical success and the incidences of, and risk factors for, mechanical and infectious complications of venous port placement in infants” Acord et al (2018).

Abstract:

PURPOSE: To evaluate technical success and the incidences of, and risk factors for, mechanical and infectious complications of venous port placement in infants.

MATERIALS AND METHODS: This was a retrospective single-institution cohort study of port placement in infants (age < 1 y) from January 2006 through June 2016 (mean age, 7.5 mo ± 3.3; mean weight, 8.1 kg ± 1.9). Age, weight, sex, side of placement, tip position, and indication for placement (chemotherapy vs other) were recorded. Total catheter-days (CDs), mechanical complications, and central catheter-associated bloodstream infections (CCABSIs) were identified.

RESULTS: During the study years, 64 ports were placed in 64 infants, with a technical success rate of 100%. The mean catheter life was 321 days (total range, 4-1,917 d; interquartile range , 107-421 d). There were 13 CCABSI events (0.63 per 1,000 CDs); of these, 8 (12.5% among 64 patients) required port removal for infection. There was an increase in CCABSIs in patients with left-sided port placement (relative risk , 3.22; 95% confidence interval , 1.02-10.14; P = .05). There were 8 mechanical complications of the port reservoir or catheter (0.39 per 1,000 CDs). Of these, 2 (3.1%) required removal. Patients in the lowest weight quartile were at an increased risk of mechanical complications (RR, 4.37; 95% CI, 1.09-17.48; P = .04).

CONCLUSIONS: Venous ports can be placed with a high rate of technical success in infants. Left-sided ports and low weight are associated with increased infectious and mechanical complications, respectively.

Reference:

Acord, M., Cahill, A.M., Krishnamurthy, G., Vatsky, S., Keller, M. and Srinivasan, A. (2018) Venous Ports in Infants. Journal of Vascular and Interventional Radiology. January 15th. .

doi: 10.1016/j.jvir.2017.10.017.

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