A prospective study of untunnelled subclavian vein catheters in hematooncology patients

In patients with hematological malignancies, we prospectively evaluated the use of untunnelled subclavian vein catheters placed either for short term chemotherapy (48 episodes) or for long-term intensive supportive care during pancytopenia (152 episodes). The 200 catheters were placed in 88 different patients. There were 2 placement failures and 2 cases of minor pneumothorax. In 4 episodes ecchymoses and in 1 uncontrollable bleeding from the exit site occurred. The mean time to removal was 25.6 days (range 0-149). There was 1 exit site infection and 26 periods of septicemia, of which 8 were considered catheter associated. All infections responded to appropriate treatment. Irreversible obstruction occurred in 4 and dislodgement in another 4 episodes out of a total number of 11 failures. Patient acceptance was high although repeated placements were frequently undertaken for successive periods of treatment and supportive care. With meticulous sterile techniques of placement and catheter care it seems that untunnelled subclavian vein catheters are reliable and safe in hematooncology.