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Subcutaneous infusion ports in the pediatric patient with hemophilia
D P Girvan1, L L deVeber, M J Inwood
1Children's Hospital of Western Ontario, Canada.
Insights
Subcutaneous infusion ports offer a safe and effective solution for long-term venous access in pediatric hemophilia patients. These devices provide reliable access for medication, improving quality of life with minimal complications.
Area of Science:
- Pediatric Hematology
- Vascular Access Devices
- Medical Devices
Background:
- Central venous access is crucial for managing pediatric conditions like malnutrition, malignancy, and infections.
- Hemophilia poses unique and often urgent challenges for venous access.
- Subcutaneous infusion ports are an established tool for long-term venous access.
Purpose of the Study:
- To evaluate the safety and efficacy of subcutaneous infusion ports in pediatric patients with hemophilia.
- To assess the long-term performance and complication rates of these devices in this population.
Main Methods:
- A retrospective review of 11 subcutaneous infusion port implantations in nine pediatric hemophilia patients.
- Data collection on device dwell time, complications, and patient/parent satisfaction.
- A survey of Canadian Hemophilia Centre Directors Group for additional data on 45 ports.
Main Results:
- The 11 implanted ports remained functional for up to 7 years with no major complications.
- Two catheters required replacement (skin erosion, blockage); one was removed (blockage).
- Survey data indicated overwhelming parental and patient enthusiasm and no major complications in 45 additional ports.
Conclusions:
- Subcutaneous infusion ports are a safe, effective, and well-tolerated solution for long-term venous access in pediatric hemophilia.
- These devices facilitate ongoing drug therapy, including for HIV-positive patients.
- The high satisfaction rates and low complication profile support their use in this patient group.
Abstract:
Central venous access devices have become important tools in the management of pediatric patients with malnutrition, malignancy, and infections requiring long-term antibiotic treatment. Hemophilia presents a lifetime challenge for venous access and at times can be an urgent or life-threatening situation. Since 1986, the authors have implanted 11 subcutaneous infusion ports in nine patients with hemophilia. The systems have remained in place for up to 7 years, without major complications or problems. Two catheters were replaced, after 4 and 6 years, because of skin erosion and blockage, respectively. One catheter was removed after 7 years because of blockage following local trauma and was not replaced. A recent survey through the Canadian Hemophilia Centre Directors Group obtained a further 45 subcutaneous infusion ports in other centers across Canada. The benefits of this system are overwhelming enthusiasm by the parents and children and no major complications. Some of the patients are now HIV-positive and are able to use their system for ongoing drug therapy.
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