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Use of subcutaneous implantable infusion systems in neoplastic and AIDS patients requiring long-term venous access
P Dionigi1, T Cebrelli, V Jemos
1Department of Surgery, University of Pavia, Italy.
Objective:
To evaluate the life span and complication rates of totally implantable infusion devices in patients with short bowel syndrome and in immunocompromised patients with AIDS, lymphoma, and myeloma who required long-term central venous access.
Design:
Prospective open study.
Setting:
University hospital, Italy.
Subjects:
Group I - 5 patients with short bowel syndrome; group II - 11 patients with AIDS; and group III - 15 patients with lymphoma or multiple myeloma (1 of whom had 2 devices implanted).
Main Outcome Measures:
Duration of implantation and incidence of catheter-related complications.
Results:
The mean duration/patient of the catheter was 422 days (range 20-1257) in group I; 104 days (range 43-262) in group II; and 415 days (range 62-1280) in group III. There were no catheter related complications in the patients in group I (short bowel syndrome). Of the 11 patients with AIDS (group II) 4 developed catheter related infections (0.32/100 catheter days), and 1 developed a thrombotic occlusion. All 5 catheters were removed (3 for infection). Of the 15 patients with lymphoma or myeloma who had 16 catheters implanted (group III), 1 patient developed 3 infective episodes (0.05/100 catheter days), 1 catheter migrated and 1 occluded. All 3 catheters were removed.
Conclusion:
Totally implantable infusion systems can safely be used for prolonged periods in immunocompromised patients, including those with AIDS if their life expectancy is reasonable.