Brown J M
IV Institute, Boerne, Texas, USA.
J Intraven Nurs. 1996 Nov-Dec;19(6):303-6.
The implanted port vascular access system has provided many patients with safe and reliable vascular access. Its implanted design provides improved body image, reduced maintenance and a better quality of life. The Huber needle has been the standard means of accessing the implanted port system. Because of the problems associated with the Huber needle system, current standards recommend that the Huber needle be changed every 7 days. This evaluation examines the use of a polymer cannula to access the implanted port system. This polymer cannula eliminates many of the problems associated with the Huber needle and provides longer dwell times without increased complications. Seventy nine patients were accessed for a total of 1533 days with the mean dwell time being 19.4 days with no increase in complications associated with port access.
To establish implanted port access times of greater than 7 days without increased complications.
A multicenter voluntary enrollment evaluation of a medical device.
Patients were offered the opportunity to participate in the evaluation if they had an implanted port and were going to be accessed for therapy for periods of 7 days or more.
Patients were observed for adverse cutaneous reactions at the insertion site and any port access complications such as sepsis, leakage, changes in portal chamber integrity, and implant pocket integrity.
From October 1994 through November 1995, 79 L-Cath for Ports (Luther Medical Products) polymer catheter port access devices (Illustration 1) were inserted in 54 patients. This polymer port access device was used instead of a rigid metal Huber needle for port access. The total number of access days was 1533 days with the mean duration of access being 19.4 days. Two patients experienced blood stream infections while they were accessed with the polymer port access device. These infections ensued with fever of unknown origin as the presenting symptom during neutropenic episodes after chemotherapy treatment. The port access device was removed and the port access device tip was cultured with culture results being negative. No other patients experienced complications related to the port access device.
The polymer port access device provided a safe and effective means of extending port access times. This reduced the number of restarts for the patients and could extend portal septum life by exposing the portal septum to fewer accesses.
植入式端口血管通路系统为许多患者提供了安全可靠的血管通路。其植入式设计改善了身体形象,减少了维护需求,提高了生活质量。胡贝尔针一直是接入植入式端口系统的标准方式。由于与胡贝尔针系统相关的问题,当前标准建议每7天更换一次胡贝尔针。本评估研究了使用聚合物套管接入植入式端口系统的情况。这种聚合物套管消除了许多与胡贝尔针相关的问题,并提供了更长的留置时间,且并发症并未增加。79名患者使用该系统共1533天,平均留置时间为19.4天,与端口接入相关的并发症并未增加。
建立植入式端口接入时间大于7天且不增加并发症的方法。
对一种医疗设备进行多中心自愿入组评估。
如果患者有植入式端口且将接受7天或更长时间的治疗,就有机会参与评估。
观察患者在插入部位的皮肤不良反应以及任何端口接入并发症,如败血症、渗漏、端口腔完整性改变和植入腔完整性改变。
从1994年10月到1995年11月,54名患者插入了79个用于端口的L - Cath(路德医疗产品公司)聚合物导管端口接入装置(图1)。该聚合物端口接入装置用于替代刚性金属胡贝尔针进行端口接入。总接入天数为1533天,平均接入时长为19.4天。两名患者在使用聚合物端口接入装置时发生了血流感染。这些感染在化疗治疗后的中性粒细胞减少期以不明原因发热为首发症状。移除端口接入装置并对端口接入装置尖端进行培养,培养结果为阴性。没有其他患者出现与端口接入装置相关的并发症。
聚合物端口接入装置提供了一种安全有效的延长端口接入时间的方法。这减少了患者重新开始治疗的次数,并通过减少对端口隔膜的接入次数来延长端口隔膜的使用寿命。