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Experiences with the use of the Port-a-Cath in children
1Department of Surgery, Children's Hospital of Eastern Ontario, Ottawa, Canada.
Insights
Port-a-Caths are effective for long-term venous access in pediatric oncology patients, showing good tolerance and durability across various ages and sizes. Insertion and use are manageable, with minimal complications reported.
Area of Science:
- Pediatric Oncology
- Medical Devices
- Vascular Access
Background:
- Central venous access devices are crucial for administering treatments like chemotherapy in pediatric patients.
- Port-a-Caths offer a long-term solution for venous access, reducing the need for repeated peripheral venipunctures.
- Assessing the safety, efficacy, and tolerance of Port-a-Caths in a pediatric oncology population is important.
Purpose of the Study:
- To evaluate the use of Port-a-Caths in pediatric patients undergoing cancer chemotherapy.
- To assess the device's performance, complications, and patient/parent acceptance.
- To determine if patient size or age impacts the successful use of Port-a-Caths.
Main Methods:
- A retrospective review of 20 Port-a-Cath insertions in 19 pediatric patients over 18 months.
- Data collected on patient demographics, indications for use, duration of catheterization, complications, and outcomes.
- Analysis of device functionality, ease of insertion and use, and patient/parent satisfaction.
Main Results:
- 20 Port-a-Caths were inserted in 19 children (8.5 months to 18 years), primarily for chemotherapy administration.
- Devices were used for an average of 27 weeks (517 patient-weeks total), with good functionality in most cases.
- Complications were infrequent, with only three removals due to issues; patient tolerance and parent acceptance were high.
Conclusions:
- Port-a-Caths are a safe and effective long-term venous access solution for pediatric cancer patients.
- Device performance and durability are not significantly limited by patient age or size.
- High patient tolerance and parent acceptance support the use of Port-a-Caths in this population.
Abstract:
Over a period of 18 months, we have inserted 20 Port-a-Caths in 19 children between the ages of 8 1/2 months and 18 years. The smallest child weighed 7 k. Three others weighed less than 12 k. The indication in all cases except two was the administration of cancer chemotherapy. The devices have been in use for periods ranging from 2 to 70 weeks (total of 517 patient weeks, average 27 weeks). Four patients had the device removed electively at termination of chemotherapy. Five patients died with the device in place and functioning well. Three patients required removal for complications. The eight others still have functioning catheters. The only significant "nuisance" problem is the occasional inability to withdraw blood. Patient tolerance and parent acceptance is good. In particular, we are impressed with the fact that ease of insertion and of use, as well as durability, do not seem to be limited by patient size or age, as long as a vessel large enough to accommodate the catheter can be found.